Key result
Traditional NSAIDs and COX-2 inhibitors are linked to higher risk of cardiovascular events.
Why the study?
The risk of cardiovascular events related to NSAID use has received much less attention despite widespread use and known gastrointestinal risks.
Are NSAIDs associated with an increased risk of cardiovascular events in patients treated for acute and chronic pain?
Are NSAIDs associated with an increased risk of cardiovascular events in patients treated for acute and chronic pain?
This review highlights the significant cardiovascular risks associated with NSAID use, emphasizing the need for careful prescription, especially in patients with underlying heart disease.
Alerts clinicians to underrecognized NSAID CV risks in chronic use; leaves open need for targeted prospective trials to refine risk mitigation.
Non steroid anti-inflammatory drugs (NSAIDs) are largely used for treatment of acute and chronic pain, even for long periods of time (months or years). While it is known that their use is frequently associated with gastrointestinal damage, including major bleedings from peptic ulcer, the risk of cardiovascular events related to NSAID has received much less attention. However, there is a large body of evidence showing that NSAIDs (both "traditional", such as diclofenac or indobufen, and selective cyclooxygenase inhibitors, COX-2) are associated with a significant increase of risk of cardiovascular events, both fatal and nonfatal. Consequently, several options have been proposed for the treatment of pain, including the use of analgesic drugs with different mechanisms of action, such as the opiates. Of interest, the Italian Drug Agency (AIFA) published a few years ago a warning (Nota 66) on the careful prescription of NSAIDs in patients with overt heart disease, such as coronary artery disease and heart failure. Aim of this paper is to present the current status of knowledge on the proper use of NSAIDs and other analgesic drugs in the management of acute and chronic pain.
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Temporelli et al. (2015) conducted a review in Acute and chronic pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) was evaluated. Nonsteroidal anti-inflammatory drugs, including both traditional agents and selective COX-2 inhibitors, are associated with a significantly increased risk of fatal and nonfatal cardiovascular events.
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