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Study Doesn't Support Drug for Pericardial Effusion

Diclofenac, placebo linked to similar effect on effusion, tamponade following cardiac surgery

TUESDAY, Feb. 2 (HealthDay News) -- In patients with pericardial effusion following heart surgery, the use of the nonsteroidal anti-inflammatory drug diclofenac doesn't reduce the size of the effusions or lower the risk of late cardiac tamponade, according to research published in the Feb. 2 issue of the Annals of Internal Medicine.

Philippe Meurin, M.D., of Les Grands Prés in Villeneuve Saint Denis, France, and colleagues analyzed data from 196 adults with moderate to large pericardial effusion more than seven days after cardiac surgery. Patients were randomized to receive placebo or 50 mg of diclofenac twice daily for 14 days.

The researchers found that the groups had similar decreases in pericardial effusion grade from baseline to 14 days. A similar number of cases of tamponade also occurred in each group (9.2 percent in the diclofenac group and 11.2 percent in the placebo group). Overall, 20 patients needed pericardial drainage a mean of 8.2 days after inclusion.

"In conclusion, [this] study and other available evidence suggest that until we have further data, clinicians should avoid the routine use of anti-inflammatory therapies in the absence of evidence of inflammation, such as elevated C-reactive protein levels or other symptoms. However, careful monitoring of postoperative pericardial effusions is warranted, especially for large effusions," writes the author of an accompanying editorial.

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