Pain Medication Linked to Higher Heart Attack Risk

Risk increases with higher dose and treatment duration of non-steroidal anti-inflammatory drugs

TUESDAY, Nov. 4 (HealthDay News) -- The risk of a heart attack increases with the use of non-steroidal anti-inflammatory drugs (NSAIDs), particularly at higher doses and with longer use, according to study findings published in the Nov. 11 issue of the Journal of the American College of Cardiology.

Luis Alberto Garcia Rodriguez, M.D., from Centro Espanol de Investigacion Farmacoepidemiologica in Madrid, Spain, and colleagues retrospectively examined the association between the use of NSAIDs and the risk of myocardial infarction using data from 8,852 non-fatal cases of myocardial infarction (in patients aged 50 to 84 years) and 20,000 controls.

The researchers found that the risk of myocardial infarction increased with current NSAID use (relative risk 1.35), which increased with treatment duration and daily dose. The degree of cyclooxygenase-2 (COX-2) inhibition in vitro was significantly associated with the risk of myocardial infarction. The risk of myocardial infarction was lower for NSAIDs that inhibited COX-2 less than 90 percent (relative risk 1.18) compared with NSAIDs with greater inhibition (relative risk 1.60), the authors report. The degree of COX-1 inhibition was not associated with the risk of myocardial infarction, the report indicates.

"Our findings suggest that the variable risk of myocardial infarction among NSAIDs that do not inhibit platelet COX-1 completely and persistently is largely related to their extent of COX-2 inhibition," Rodriguez and colleagues conclude.

The study was funded by an unrestricted research grant from Pfizer and a grant from the European Community's Sixth Framework Program.

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