CVD Risk Compared Across Various NSAIDs

Previous studies have indicated that non-steroidal anti-inflammatory drugs (NSAIDs) are associated with increased cardiovascular (CV) risks. However, a new study has indicated that there is no difference in risk across individual NSAIDs except with mefenamic acid use.

For their study, the researchers assessed patients with hypertension who initiated COX-2 selective NSAIDs (n = 2749) and nonselective NSAIDs (n = 52,880) for any hospitalizations for ischemic stroke, acute myocardial infarction, congestive heart failure, and other CV conditions. Follow-up lasted 4 weeks.
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Following adjustment, the hazard ratio (HR) of major CV events associated with COX-2 selective NSAID use vs nonselective NSAID use was 1.07. Results indicated no differential risk for major CV events when comparing celecoxib with diclofenac (HR 1.17) ibuprofen (HR 1.36), or naproxen (HR 0.75).

However, when compared with mefenamic acid use (HR 2.11), the researchers observed an increased risk for major CV events compared with COX-2 selective NSAID use.

“Our results provide important information about the comparative cardiovascular safety of NSAIDs in patients with hypertension,” the researchers concluded.

—Christina Vogt

Reference:

Dong YH, Chang CH, Wu LC, Hwang JS, Toh S. Comparative cardiovascular safety of non-steroidal anti-inflammatory drugs in patients with hypertension: a population-based cohort study [Published online February 22, 2018]. Br J Clin Pharmacol. doi:10.1111/bcp.13537.