Risk Of Acute Myocardial Infarction With NSAIDs In Real World Use

[Elias]

This article appeared in BMJ. Surprisingly, it made front page headline news in our hospital's news section, where I work.

Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data | The BMJ

 

[lollipop]

From the study:

"Taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction. With use for one to seven days the probability of increased myocardial infarction risk (posterior probability of odds ratio >1.0) was 92% for celecoxib, 97% for ibuprofen, and 99% for diclofenac, naproxen, and rofecoxib. The corresponding odds ratios (95% credible intervals) were 1.24 (0.91 to 1.82) for celecoxib, 1.48 (1.00 to 2.26) for ibuprofen, 1.50 (1.06 to 2.04) for diclofenac, 1.53 (1.07 to 2.33) for naproxen, and 1.58 (1.07 to 2.17) for rofecoxib. Greater risk of myocardial infarction was documented for higher dose of NSAIDs. With use for longer than one month, risks did not appear to exceed those associated with shorter durations."

@Elias or anyone know if these are the same as plain Aspirin?

 

[Elias]

Aspirin was not included in the study. Aspirin has a different pharmacokinetic profile from the NSAID's studied.

"The NSAIDs of interest were celecoxib, the three main traditional NSAIDs (diclofenac, ibuprofen, and naproxen), and rofecoxib"

 

[lollipop]

Aspirin was not included in the study.

"The NSAIDs of interest were celecoxib, the three main traditional NSAIDs (diclofenac, ibuprofen, and naproxen), and rofecoxib"

Thank you.

 

[haidut]

From the study:

"Taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction. With use for one to seven days the probability of increased myocardial infarction risk (posterior probability of odds ratio >1.0) was 92% for celecoxib, 97% for ibuprofen, and 99% for diclofenac, naproxen, and rofecoxib. The corresponding odds ratios (95% credible intervals) were 1.24 (0.91 to 1.82) for celecoxib, 1.48 (1.00 to 2.26) for ibuprofen, 1.50 (1.06 to 2.04) for diclofenac, 1.53 (1.07 to 2.33) for naproxen, and 1.58 (1.07 to 2.17) for rofecoxib. Greater risk of myocardial infarction was documented for higher dose of NSAIDs. With use for longer than one month, risks did not appear to exceed those associated with shorter durations."

@Elias or anyone know if these are the same as plain Aspirin?

I can't get access to this one but the previous one I posted that looked at the same drugs found that aspirin was the one drug that did NOT increase risk of hearts attacks or heart failure.
NSAID Other Than Aspirin Strongly Increase Risk Of Cardiac Arrest, Heart Failure, And Stroke

 

[lollipop]

I can't get access to this one but the previous one I posted that looked at the same drugs found that aspirin was the one drug that did NOT increase risk of hearts attacks or heart failure.
NSAID Other Than Aspirin Strongly Increase Risk Of Cardiac Arrest, Heart Failure, And Stroke

I remembered you posted that one and saved it. Just checking with this study. I must thank you because occasional Aspirin is helping me tremendously and really your postings gave me the confidence to try. A bit like a miracle substance...

Need to look back and reread carefully why these other NSAIDS are causing so many problems. Again thank you!

 

[tankasnowgod]

Huge warning with these studies- These were totally observational, and not RCT. While I can certainly see a potential causative role with various NSAIDS, most people only take these drugs when they experience pain. While there can be a whole host of confounding factors in any sort of observational study, this one has major obvious one.

It's possible that NSAIDS are simply a marker of the signs of an impending heart attack.

That said, the fact that aspirin is NOT associated with heart disease is an even greater point for aspirin.

 

[Such_Saturation]

Lol "in real world use" new buzzword for observational studies