NSAIDs increase risk of MI within one week of treatment initiation

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The increased risk was seen with celecoxib, ibuprofen, diclofenac, naproxen, and rofecoxib.

Common NSAIDs, including ibuprofen and naproxen, can increase risk of myocardial infarction (MI) within just one week of use, according to a new study published in the BMJ.

Previous studies have suggested that both traditional and selective COX-2 NSAIDs increase the risk of acute MI but the timing of the risk, the effect of dose and treatment duration, and the comparative risks between NSAIDs is still poorly understood.

This systematic review and meta-analysis of available evidence found that taking any dose of NSAIDs for one week, one month, or more than a month was associated with increased risk of MI. Likelihood of MI within one week of treatment initiation was increased by 24 per cent with celecoxib, 48 per cent with ibuprofen, 50 per cent with diclofenac, 53 per cent with naproxen, and 58 per cent with rofecoxib. Greater risk was seen with higher doses of NSAIDs.

“Given that the onset of risk of acute myocardial infarction occurred in the first week and appeared greatest in the first month of treatment with higher doses, prescribers should consider weighing the risks and benefits of NSAIDs before instituting treatment, particularly for higher doses,” the authors concluded.

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