Be careful with NSAIDs!
Taking painkillers for acute respiratory viral infections is associated with an increased risk of heart attack
Anna Stavina, XX2 century, based on ScienceDaily: Common pain relievers may increase heart attack risk during respiratory infections
Taking painkillers during acute respiratory viral infections or flu may increase the likelihood of developing a myocardial infarction. The results of a new study suggest that both doctors and patients should be cautious about prescribing (or using) nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve symptoms of respiratory disease.
In the course of an observational study, scientists analyzed data from Taiwan's national health insurance program for a seven-year period, from 2005 to 2011. In particular, the sample included about 10 thousand patients hospitalized for myocardial infarctions. The researchers decided to find out how two known risk factors – taking NSAIDs and respiratory infection – collectively affect the likelihood of a heart attack.
Scientists compared the overall risk of developing a heart attack in each individual patient with his own personal risks during periods of respiratory diseases and taking NSAIDs. It turned out that the use of anti-inflammatory drugs is associated with a 3.4-fold increase in the likelihood of a heart attack. If the patient received painkillers in the hospital, intravenously, then the risk of developing a heart attack increased by 7.2 times compared to the period when there was no respiratory disease or NSAID intake.
ARVI disease without the use of nonsteroidal anti–inflammatory drugs was associated with an increase in the probability of a heart attack by 2.7 times, and taking NSAIDs in the absence of respiratory infection - by 1.5 times. In previous works of ARVI and NSAIDs were considered as possible triggers provoking the occurrence of heart problems. However, these factors have always been evaluated separately from each other.
"Doctors should be aware that the use of NSAIDs in patients with respiratory infections can increase the risk of myocardial infarction," says study author Dr. Cheng–Chung Fang from the National Taiwan University Hospital. – Patients who would like to relieve flu or cold symptoms should consult a doctor or pharmacist before starting NSAIDs. Another common painkiller, acetaminophen (in Russia, this remedy is better known as paracetamol), may be a safer alternative to nonsteroidal anti-inflammatory drugs for the heart. However, acetaminophen has not been studied in this study."
Although the new work investigated the relationship between the use of NSAIDs, acute respiratory infections and the risk of myocardial infarction, the design of the study did not allow to establish causal relationships. To clarify exactly how the combination of these two risk factors affects the heart, and to develop a strategy for managing the risks detected, additional work will be required. For example, it may turn out that some NSAIDs are safer for the heart than others. It is also necessary to find out to what extent the severity of SARS or influenza affects the risk of heart attack, as well as to identify particularly vulnerable groups of patients.
The results of the study are published in the Journal of Infectious Diseases (Wen et al., Acute Respiratory Infection and Use of Nonsteroidal Anti-Inflammatory Drugs on Risk of Acute Myocardial Infarction: A Nationwide Case-Crossover Study).
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07.02.2017