NSAIDs boost heart attack risk within a week of use

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Prior studies had pointed to an increase in heart attack risk from using NSAIDs, but this study looked at timing, dose and the duration of taking the medicine.

Because of the observational nature of the research, which examined the prescribing data and health outcomes of more than 446,000 people, scientists can not say for sure why anti-inflammatories are linked to greater heart attack risk. At the time, she was an epidemiology doctoral student at McGill University in Canada.

The increased risk of heart attack associated with NSAIDs was seen at any dose taken for one week, one month or more than one month.

"The recommendation to avoid in the highest-risk patients and use the lowest dose still stands".

Even people taking the occasional tablet for backache have been warned to consider alternatives and not assume that drugs are totally safe because they can be bought easily at a supermarket.

"It remains possible that the painkillers aren't actually the cause of the extra heart attacks". The study type was observational and it allowed the researchers to conclude that all NSAIDs studied are connected to a maximum of heart attack risk, the probability being greater than 90%. The risk declines after discontinuing the NSAIDs. NSAIDs are available both with a prescription and over the counter. Pooling large populations is particularly helpful when studying a rare adverse drug event. In total, they analysed data on 446,763 patients of whom 61,460 had an MI.

In this type of study, called a meta-analysis, researchers attempt to find common trends within diverse studies. Health related data was cross-referred with the medical history of the people, in relation to three common anti-inflammatory painkillers: ibuprofen, diclofenac and naproxen.

About 190,000 people a year go to hospital due to heart attacks in the United Kingdom, according to the British Heart Foundation.

According to the results, there was a greater heart attack risk as soon as the first week of taking NSAIDs, and such risk elevated with higher doses.

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Use for between eight and 30 days at a high dose was "particularly harmful" when people were taking more than 1,200mg a day of ibuprofen, 750mg a day of naproxen and more than 25mg a day of rofecoxib, they wrote.

Researchers cautioned that even though the results did not show that the risk continued when the treatment duration was extended, and so it is suggested to use NSAIDs for a short time period as much as possible, as repeat heart attacks was not covered in the study.

Patients should be aware of their own risk for heart disease and discuss NSAID use with their doctor, Bally said.

The research was ambitious, said Muhammad Mamdani, a scientist at the Li Ka Shing centre at St. Michael's Hospital and a pharmacy professor at the University of Toronto.

"The absolute risk is small, but all individuals considering the use of these medications should carefully weigh the benefits against this increased risk", Fonarow said.

Associate medical director of the British Heart Foundation Dr Mike Knapton told the Telegraph the study "worryingly" highlighted the risks. He advised that it offered "no reason to induce anxiety in most users of these drugs".

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