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Patients with ischemic heart disease prescribed NSAIDs at increased risk for MI, death
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Thirty-six percent of patients who were prescribed nonsteroidal anti-inflammatory drugs had ischemic heart disease or cardiovascular risk factors, increasing their risk for myocardial infarction or death, according to research presented at the annual congress of the European League Against Rheumatism in Madrid.
“The side effect profile and safety of nonsteroidal anti-inflammatory drugs has been commonly reported, but little is known about treatment duration and its implications for cardiovascular risk,” researcher Carl Orr, MD, department of medicine, Royal College of Surgeons in Dublin, said in a press release.
Orr and colleagues used data from a large Irish primary care facility to identify patients aged older than 50 years with a history of myocardial infarction (MI) who had been prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) for even less than 1 week. Patients with ischemic heart disease (IHD), diabetes mellitus and/or hypertension were identified, and treatment indication and prescription duration were recorded.
Patients in primary care with rheumatic problems are commonly prescribed NSAIDS as treatment, the researchers noted.
Of the 10,000 patients registered with the practice, 108 were prescribed NSAIDs, including diclofenac in 56% of cases, during a 2-month period in 2012. Mean treatment duration among the 39 patients diagnosed with IHD or risk factors for cardiovascular disease was 265 days. Twenty-two patients were prescribed NSAIDs for longer than 1 month, and six were prescribed the drugs for at least 1 year.
“These data demonstrate an immediate increase in the risk of death and MI, challenging the safety of even short-term use,” Orr said. “The introduction of physician guidelines to assist safe prescribing of this class of drug is vital.
“We find it disconcerting that diclofenac was prescribed in 56% of cases and suggest that recommendations to switch to safer alternatives are a critical component of any physician guidelines.”
For more information:
Orr C. OP0203-PC: New Data, New Problem; Assessing the Prevalence of NSAID Prescribing in Primary Care in Those With a Background of Ischemic Heart Disease (IHD) or Risk Factors for IHD. Presented at: EULAR 2013; June 12-15, Madrid.