Warning on ibuprofen use in patients with cardiovascular disease

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Researchers are advising avoidance of diclofenac and ibuprofen in patients with cardiovascular disease or a number of cardiovascular risk factors.

Non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk, but until now it remained unknown whether their use was associated with out-of-hospital cardiac arrest (OHCA).

In a new study, published in the European Heart Journal – Cardiovascular Pharmacotherapy researchers examined data relating to 28,947 individuals with OHCA from the nationwide Danish Cardiac Arrest Registry. A total of 3,376 of these patients were treated with an NSAID up to 30 days before OHCA.

The authors found use of any NSAID was associated with a 31 per cent increased risk of cardiac arrest. 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.
“The findings are a stark reminder that NSAIDs are not harmless,” said Professor Gunnar H. Gislason, professor of cardiology at Copenhagen University Hospital Gentofte, Denmark. “Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest. NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors.”

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