Heart patients who used common pain relievers called NSAIDs even briefly are at much higher risk of having a repeat heart attack or of dying than those who stay away from the drugs, which include such widely used over-the-counter medications as ibuprofen and naproxen, a
The research, published Tuesday in the American Heart Assn.'s journal,
, suggests that for patients who have suffered a heart attack, even short-term use of NSAIDs, or nonsteroidal anti-inflammatory drugs for headaches, back pain or sore muscles and joints is a bad idea.
in the last seven years has
to an increased risk of heart attacks and strokes. In the process, cardiologists and primary care physicians have been warned that patients with established cardiovascular disease should avoid taking NSAIDs for long periods of time, but suggest that brief or episodic use is probably safe.
The latest study establishes that despite safety concerns about this class of drugs for such patients, the medications are used by many in the wake of a heart attack. Of 83,677 Danish heart attack patients followed in the study, 42.3% received NSAIDs from Danish pharmacies, which keep records that allowed researchers to piece together each patient's medication history. In all, 35,257 of those patients had a repeat heart attack or died.
Among the widely used pain relievers, researchers found the risk of heart attack or death rose immediately three- to fourfold with the use of
, an arthritis medication sold under the commercial names Voltaren and Cataflam, and continued to be elevated--although less dramatically than in week one, for 14 weeks of use. The risk of death or repeat heart attack showed deven steeper increases with the use of
(commercially marketed as Celebrex) and Rofecoxib (marketed as
until September 2004 when its maker voluntarily withdrew the drug from the worldwide market). But those risks peaked in weeks four and six of use, respectively.
Ibuprofen --sold under such commercial names as Motrin and Advil--proved the safest of the NSAIDs, but did elevate the risk of death or a repeat heart attack slightly, peaking in week six. Naproxen (marketed as Naprosyn and Aleve) also was associated with a slight rise in death or heart attack risk, but the peak in that risk came in the first week of use.