Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM
Use of nonsteroidal anti-inflammatory drugs (NSAIDs) for even 1 week is associated with increased risk for myocardial infarction, a meta-analysis in The BMJ finds.
Using individual patient data from four studies from healthcare databases, researchers identified over 61,000 cases of acute MI and 385,000 controls without MI. Compared with NSAID nonuse, current use of each NSAID studied — including diclofenac, ibuprofen, naproxen, and celecoxib — was associated with increased MI risk. The elevated risk was not higher for celecoxib than for other NSAIDs.
The increased risk generally emerged during the first week of use and was highest during the first month. Higher doses were also associated with greater risks.
Dr. Harlan Krumholz, editor-in-chief of NEJM Journal Watch Cardiology, weighed in: “People, particularly those at high risk for cardiac disease, should be aware of these risks as they contemplate use of these popular medications. This large study further reinforces that these risks are large enough to be meaningful for many patients.”