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Many Pain Relievers Not Linked to Heart Risks

In older individuals, naproxen users had lower risk of cardiovascular events than non-users

THURSDAY, Sept. 11 (HealthDay News) -- Many coxibs and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) don't appear to raise the risk of cardiovascular disease events, according to research published in the Aug. 15 issue of Arthritis Care & Research.

Daniel H. Solomon, M.D., of Brigham and Women's Hospital in Boston, and colleagues analyzed data from Medicare beneficiaries who participated in pharmaceutical-assistance programs for older adults. The primary outcome was a composite of hospitalization for myocardial infarction, stroke or congestive heart failure, or non-hospital death attributable to cardiovascular disease.

The study sample contained 76,082 new users of coxibs, 53,014 new users of non-selective NSAIDs and 46,558 non-users. Compared with non-users, users of rofecoxib had a higher risk (hazard ratio, 1.22) and users of naproxen had a lower risk (hazard ratio, 0.79), the researchers report. Ibuprofen use in many patient subgroups also appeared to increase the risk. Factors associated with a higher risk of cardiovascular events in users of certain coxibs or non-selective NSAIDs included age of 80 or older, hypertension, prior myocardial infarction and chronic renal disease, the report indicates.

"The additive interaction and stratified analyses suggest that rofecoxib and ibuprofen are the only agents consistently associated with an increased risk for cardiovascular disease events among specific patient subgroups," the authors write. The study's findings "should bolster physicians' and patients' confidence that most coxibs and non-selective NSAIDs are not associated with an elevated risk of cardiovascular disease events in many patient subgroups using typical doses."

The study was sponsored by Pfizer, and Solomon and several co-authors disclosed financial relationships with several pharmaceutical companies.

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