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Heart Disease Health Center

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NSAID Pain Relievers Raise Heart Risks

Study: NSAIDs Associated With Increased Risk of Heart Attacks and Strokes


It wasn’t until relatively recently, after a study found that the painkiller Vioxx was associated with significant increases in the risks of heart attacks and strokes, that doctors started to wonder if other drugs in this class might have heart risks, too. Vioxx was taken off the market in 2004.

“We found, almost inadvertently, that these drugs can have cardiovascular effects. We were sort of caught without sufficient knowledge base to guide clinical practices,” Ray says.

“There are differences in the various NSAIDs and these differences might well confer differences in cardiovascular risk. We really have less information than we need about the comparative safety of these drugs,” he says.

Measuring Heart Risks in NSAIDs

For the study, Swiss researchers pooled data from 31 randomized, controlled trials, which are considered the “gold standard” of scientific evidence. The trials included more than 116,000 patients.

The study also made use of innovative statistical methods that allowed researchers to compare the relative safety of different NSAID medications, even if they’d never gone head-to-head in the same clinical trial.

The medications, which are part of the NSAID class of medications, include many names familiar to American medicine cabinets, including ibuprofen, naproxen, diclofenac (Cataflam, Voltaren) and Celebrex.

In addition, researchers looked at the relative cardiovascular risks associated with three other drugs not sold in the U.S., including Vioxx, Arcoxia, and Prexige. Those drugs, structurally similar to Celebrex, are part of a special subset of the NSAID class known as Cox-2 inhibitors.

Overall, naproxen appeared to have the safest cardiovascular risk profile of the seven included in the review.

Compared to placebos, Vioxx and Prexige were associated with twice the risk of heart attack.

Ibuprofen was associated with more than three times the risk of stroke, compared to a placebo. Diclofenac was associated with almost four times the risk of cardiovascular death.

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