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NSAIDS Risky for Heart Patients

Feb 4, 2009 | Parker Waichman LLP Use of non-steroidal anti-inflammatory drugs—NSAIDs—has, yet again, been linked to dangerous risks for cardiac patients.  ABC Local reported that, according to a study published in the Archives of Internal Medicine, NSAIDs have been linked with increased risks of death and cardiovascular illness in patients suffering from chronic heart failure.

NBC Local noted that NSAIDs such as Vioxx, Celebrex, ibuprofen, and naproxen, were associated with the dangerous adverse effects.  It is not yet known if lowered doses decrease the risks.

NSAIDs are the most prescribed medications for treating conditions such as arthritis. The Food & Drug Administration (FDA) now requires all NSAIDs to bear a black box warning—the strongest FDA warning—regarding heart attack and stroke risks.  The warnings were added to the drugs after Vioxx was recalled in 2004.

The FDA ordered Vioxx off the market in 2004 after studies showed that people who took the drug had a higher risk for heart attack. The recall came after an analysis of patients using Vioxx linked the defective drug to more than 27,000 heart attacks or sudden cardiac deaths in the U.S. from 1999 through 2003.  Since then, Vioxx has been the subject of thousands of drug injury lawsuits.

In November, Danish researchers discovered that the risk of a second heart attack or death actually doubled within the first 90 days of starting Vioxx or Celebrex; ibuprofen increased the risk between 2.1 and 1.3 times.  At that time, a study researcher presenting at an American Heart Association meeting, recommended physicians avoid these types of painkillers, or use low doses, in patients with a history of heart attack or heart failure.

For their study, researchers at the University of Copenhagen analyzed the records of over 58,000 patients who had a previous heart attack and nearly 108,000 with heart failure in Denmark. Of those, 36 percent of the heart attack patients and 34 percent of the heart failure patients said they took at least one painkiller after they were discharged from the hospital.

Patients who had suffered a heart attack and were taking the painkiller Vioxx had 2.7 times the risk of having another heart attack or dying compared with patients not taking painkillers. Heart attack patients taking Celebrex had double the risk, while those with heart failure taking Celebrex had 2.3 times the risk. Heart attack patients taking diclofenac had 1.9 times the risk, while those taking ibuprofen had 1.3 times the risk, according to the study.

An earlier study, also looking at the correlation between an increased risk of heart attack and stroke and use of NSAIDs revealed similar results.  The study, conducted by researchers in Spain and Italy, looked at nearly 9,000 people who had heart attacks and who had taken NSAIDs.  The cardiac risk increase found in this group was related to both the dosage and the length of time the NSAID drugs were taken.  But the risk was increased by 18 percent by NSAIDS that acted  against cox-1, compared to a 60 percent increase for those with the greatest cox-2 activity.



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