‘Harmless’ NSAIDs have cardiac arrest risk, says study

Non-steroidal anti-inflammatory drugs (NSAIDs) are associated with an increased risk of cardiac arrest and should only be used after consulting a healthcare professional, says a new study published in the European Heart Journal – Cardiovascular Pharmacotherapy.

The Danish study looked at all patients on the Danish Cardiac Arrest Registry who had an out-of-hospital cardiac arrest in Denmark between 2001 and 2010. Data was collected on all redeemed prescriptions for NSAIDs from Danish pharmacies since 1995, including the non-selective NSAIDs (diclofenac, naproxen, ibuprofen), and COX-2 selective inhibitors (rofecoxib, celecoxib). Information was not obtained on over-the-counter drugs.

Exposure to NSAIDs 30 days before cardiac arrest (case period) was assessed and compared with exposure to NSAIDs in a preceding 30-day period where the individual did not experience an event (control period). Researchers found a 31 per cent increased risk of cardiac arrest associated with the use of any NSAID. Diclofenac and ibuprofen were associated with a 50 per cent and 31 per cent increased risk, respectively. Naproxen, celecoxib and rofecoxib were not associated with the occurrence of cardiac arrest, probably due to a low number of events.

Professor Gunnar H. Gislason, professor of cardiology at Copenhagen University Hospital Gentofte and lead author of the study, commented that even though the research focused on prescription-only NSAIDs, being able to buy these over the counter without a prescription sends a message to the public that they're safe. He added: “I don’t think these drugs should be sold in supermarkets or petrol stations where there is no professional advice on how to use them. Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities, and in low doses.”

In response to the study, John Smith, PAGB chief executive, said: “The authors admit that the study has several limitations and highlight that it reports only associations and therefore any conclusions should be made with caution."

Mr Smith added: “It is important for people with a history of heart disease or other long-term condition to speak to a pharmacist before taking any OTC medicine to check for any potential drug interactions or health concerns. OTC medicines should only be taken in accordance with the on-pack instructions and patient information leaflet. Anyone who has concerns about taking a medicine should speak to a pharmacist for advice.”


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