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Analysis Supports Cardiovascular Concern With NSAIDs

Nonsteroidal anti-inflammatory drugs tied to higher risks of heart attack, stroke, CV death in meta-analysis

WEDNESDAY, Jan. 12 (HealthDay News) -- Commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) may increase the risk of heart attack, stroke, and death, according to a meta-analysis published Jan. 11 in BMJ.

Sven Trelle, M.D., of the University of Bern in Switzerland, and colleagues analyzed 31 randomized controlled trials comparing the cardiovascular safety of any NSAID treatment with other NSAIDs or placebo in a total of 116,429 patients who were allocated to naproxen, ibuprofen, diclofenac, celecoxib, etoricoxib, rofecoxib, lumiracoxib, or placebo.

The researchers found that the number of harmful outcomes overall was low; however, compared with placebo, there were risks associated with the NSAIDs. Rofecoxib and lumiracoxib were associated with the highest risks of myocardial infarction (rate ratios, 2.12 and 2.00, respectively), ibuprofen and diclofenac with the highest risk of stroke (rate ratios, 3.36 and 2.86, respectively), and etoricoxib and diclofenac with a four-fold increase in risk of cardiovascular death.

"Although uncertainty remains, little evidence exists to suggest that any of the investigated drugs are safe in cardiovascular terms. Naproxen seemed least harmful. Cardiovascular risk needs to be taken into account when prescribing any NSAID," the authors write.

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