A Popular Painkiller Ingredient Increases Risks Of Heart Attack By 50%

Diclofenac could increase heart failure

Dr Schmidt's team found in the study - published in the British Medical Journal - that patients using the drug were more likely to suffer heart problems.

The potential link between non-aspirin NSAIDs and cardiovascular has been a major concern since the thromboembolic risks associated with rofecoxib were reported back in 2005, the researchers write. Considering its cardiovascular and gastrointestinal risks, however, there is little justification to initiate diclofenac treatment before other traditional NSAIDs. Diclofenac is categorised as an essential medicine in more than 70 countries, according to a 2013 study.

"Diclofenac poses a cardiovascular health risk compared with non-use, paracetamol use, and use of other traditional nonsteroidal anti-inflammatory drugs", explain the authors. Then they used this data to emulate hundreds of clinical trials at once. During the follow-up period, between 1996-2016, the scientists eliminated other risk factors for cardiovascular diseases in the subjects who participated in the study.

The overall patient population included 1,370,832 diclofenac initiators who met the inclusion criteria, 3,878,454 ibuprofen initiators, 291,490 naproxen initiators, 764,781 matched paracetamol initiators, and 1,303,209 matched non-initiators (patients who took none of the painkillers during the study period).

Average age was 46-49 years among participants starting NSAIDs and 56 years among those starting paracetamol.

In those who took diclofenac for 30 days, the risk rose by a huge 50% - compared to those not taking any drugs. Among patients at moderate baseline risk, corresponding figures were seven, seven, eight and 14 additional events, respectively, and for those at high baseline risk, corresponding numbers were 16, 10, one and 39 additional events, respectively.

Researchers found that the increased risks applied to men and women of all ages and also those taking low doses of diclofenac.

Starting diclofenac was also associated with an increased rate of cardiac death compared with no NSAIDs, and an increased risk of upper gastrointestinal bleeding compared with no NSAIDs, starting ibuprofen or paracetamol, but not with naproxen.

The researchers pointed out the absolute risk of heart attack, stroke or other cardiovascular disease still remained low for individual patients.

In 2004, a recently approved painkiller belonging to the widely used non-steroidal anti-inflammatory drug (NSAID) class was pulled from the market after investigators revealed that the drug induced an unacceptably high number of heart attacks and stroke-causing blood clots. But even so, researchers say that the risk is not really justified.

By the way, the worst result was recorded for those people who took the drug at a lower dose than this required.

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