Despite contraindications in patients with existing cardiovascular disease, many are still given short-term courses of NSAIDs. Based on their results, the researchers did not recommend the use of NSAIDs, either short- or long-term, for patients who had previous heart attacks.
“Our results indicate that there is no apparent safe therapeutic window for NSAIDs in patients with prior heart attack,” said Anne-Marie Schjerning Olsen, MB, lead author of the study and research fellow at Copenhagen University in Hellerup, Denmark.
The study (Circulation 2011:123:2226-2235) included a group of patients (n=83,677) older than age 30 years who had suffered heart attacks during a 10-year period. Researchers reported a 45% increase in risk for death and recurrent heart attacks within as little as one week of NSAID therapy. The number increased to 55% after three months of treatment.
Although almost all NSAIDs were linked to an increased safety risk, the traditional NSAID diclofenac was associated with an almost three-times-higher risk than any of the other NSAIDs studied. Researchers also noted that the use of over-the-counter NSAIDs was unlikely to have a major impact on the study results.
Researchers suggested that in the event that NSAID therapy is necessary, doctors should limit use to the “absolute minimum” in patients with prior heart disease.