Commonly used anti-inflammatory painkillers have been linked to an increased risk of cardiac arrest, according to a research published in the European Heart Journal – Cardiovascular Pharmacotherapy.
Non-steroidal anti-inflammatory drugs, or NSAIDs, are widely available both over-the-counter and by prescription and include ibuprofen (sold OTC as Advil) and naproxen (sold OTC as Aleve). “Previous studies have shown that NSAIDs are related to increased cardiovascular risk which is a concern because they are widely used,” said the study’s lead author Professor Gunnar H. Gislason, professor of cardiology at Copenhagen University Hospital Gentofte in Denmark. “Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message that they must be safe.”
The study set out to investigate the link between NSAID use and cardiac arrest, the sudden cessation of the function of the heart that is usually fatal. Researchers looked at data from the nationwide Danish Cardiac Arrest Registry for all patients who had suffered an out-of-hospital cardiac arrest in Demark from 2001 to 2010. They also obtained data on all redeemed prescriptions for NSAIDs from pharmacies since 1995, including NSAIDs (diclofenac, naproxen, ibuprofen) and another type of medication COX-2 selective inhibitors (rofecoxib, celecoxib).
Researchers compared patients who used NSAIDs during the 30 days before suffering a cardiac arrest with patients who used NSAIDs during a proceeding 30-day period without cardiac arrest. Of the nearly 29,000 people who suffered a cardiac arrest, 3,376 were treated with NSAIDs up to 30 days before the cardiac event. That translates to a 31 percent increased risk of cardiac arrest with NSAIDs
The greatest risk was seen with dicolofenac and ibuprofen. Naproxen, celecoxib and rofecoxib were not associated with cardiac arrest.
“Do not take more than 1200 mg of ibuprofen per day,” Gislason cautioned. “Naproxen is probably the safest NSAID and we can take up to 500 mg a day. Diclofenac is the riskiest NSAID and should be avoided by patients with cardiovascular disease and the general population. Safer drugs are available that have similar painkilling effects so there is no reason to use diclofenac.”