Short-term use of some NSAIDs could be dangerous to heart attack survivors

Even short-term use of some painkillers could be dangerous for people who have had a heart attack, increasing their risk of a second attack and death, according to research published in Circulation, the Journal of the American Heart Association. The findings are similar to those posted on bmj.com (British Medical Journal) earlier this year (The Pharma Letter January 13).

Researchers in Denmark analyzed the duration of prescription non-steroidal anti-inflammatory drugs (NSAIDs) treatment and cardiovascular risk in a nationwide Danish cohort of patients with prior heart attack. They found the use of NSAIDs was associated with a 45% increased risk of death or recurrent heart attack within as little as one week of treatment, and a 55% increased risk if treatment extended to three months. The study was limited by its observational nature and the lack of clinical parameters, researchers said.

NSAIDs are commonly used by the general population and are associated with increased cardiovascular risk in people with heart disease or those at high risk. In a 2007 statement, the American Heart Association advised physicians about the risks of NSAID use among heart patients and provided a stepped care approach. In addition, the statement advised extra caution for when NSAIDs might be used, noting that they should "be limited to patients for whom there are not appropriate alternatives, and then, only in the lowest dose and for the shortest duration necessary."