Common Pain Relievers May Increase Risk of MI During Respiratory Infections

Widely used pain relievers may increase the risk of a myocardial infarction (MI) when used during a cold or flu-like illness, according to a study published in the Journal of Infectious Diseases.

The findings suggest that physicians and patients should use caution when prescribing or taking nonsteroidal anti-inflammatory drugs (NSAIDs) to ease symptoms of acute respiratory infections.

For the study, the researchers analysed claims from Taiwan’s National Health Insurance Program over a 7-year period (2005-2011), including data from nearly 10,000 patients who were hospitalised for a MI. The researchers compared each patient’s own risk for MI over time, across episodes of respiratory illness and NSAID use.

The researchers found a stronger association with a MI when both risk factors were present. Using the pain relievers during an acute respiratory infection was associated with a 3.4-fold increased risk for a MI, with 7.2 times greater risk when patients received the pain-relieving medication intravenously in the hospital, compared with times when patients had neither of the risk factors.

The risk for MI when patients with an acute respiratory illness were not taking an NSAID was 2.7 times greater, while the risk was 1.5 times greater when individuals took the drugs and did not have an infection.

Previous research has implicated respiratory infections and some NSAIDs as potential triggers for heart problems, but earlier studies have examined these risk factors only separately.

“Physicians should be aware that the use of NSAIDs during an acute respiratory infection might further increase the risk of a heart attack,” said Cheng-Chung Fang, MD, National Taiwan University Hospital, Taipei City, Taiwan. “Patients seeking relief from cold and flu symptoms should consult with their doctor or a pharmacist before using NSAIDs.”

While the study’s findings suggest an association between NSAID use, acute respiratory infections, and increased cardiac risk, they do not prove a cause-and-effect relationship. Additional research is needed to clarify the apparent combined effect on risk and how the effect might be managed.