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Painkillers Linked to Heart Rhythm Disorder

Study Suggests NSAIDs, Cox-2 Inhibitors May Raise Risk of Atrial Fibrillation
WebMD Health News
Reviewed by Louise Chang, MD

July 6, 2011 -- Widely used anti-inflammatory pain relievers may increase the risk of atrial fibrillation, a common heart rhythm disorder associated with stroke and heart failure.

In a newly published study from Denmark, use of non-selective, nonsteroidal anti-inflammatory drugs (NSAIDs) and Cox-2 inhibitors was associated with a significantly increased risk for atrial fibrillation.

Non-selective NSAIDs include the active ingredients in drugs such as Advil, Motrin and Aleve, and Naprosyn. The prescription drug Celebrex is a Cox-2 inhibitor. The researchers also included older Cox-2 inhibitor drugs such as diclofenac (Voltaren), etodolac (Lodine), and meloxicam (Mobic).

The risk was highest for new users of the drugs. New NSAID users had a 46% increase in risk, and new Cox-2 inhibitor users had a 71% increase in risk compared to people who did not take the pain relievers.

WebMD contacted Pfizer -- the maker of Advil, Celebrex, and the non-selective NSAID Feldene -- for comment. Jimison MacKay, a spokesman for Pfizer, says the study "does not change Pfizer’s understanding of the benefit-risk profile of NSAIDs, an important treatment option for appropriate patients."

"Pfizer recognizes the importance of research that has the potential to advance therapy and improve the lives of patients," MacKay says. "This retrospective observational analysis has a number of limitations that are acknowledged in the manuscript. Further studies and preferably randomized clinical trials are warranted to establish the cardiovascular profile of NSAIDs."

NSAIDs and Heart Flutter

Atrial fibrillation risk increases with age, with close to one in 10 people over the age of 80 affected by the condition.

Recent studies have linked regular use of NSAIDs, including Cox-2 inhibitor pain relievers, to an increased risk for other heart conditions in both heart patients and older people without cardiovascular disease.

But the Danish study, published July 4 in the journal BMJ, is among the first to suggest an association with atrial fibrillation or flutter, which affects around 2 million Americans.

The study included just over 32,500 Danish patients diagnosed with atrial fibrillation or flutter between 1999 and 2008. Each case was compared with 10 patients who did not have the heart condition.

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