Wednesday 25 February 2015

Certain Painkillers Ill-Advised After Heart Attack: Study

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If you're taking anti-clotting drugs, you should avoid meds like ibuprofen and Celebrex, doctors say


WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

TUESDAY, Feb. 24, 2015 (HealthDay News) -- Common painkillers such as ibuprofen and Celebrex may raise the risk for heart attack, stroke and/or serious bleeding among heart attack survivors taking prescription blood thinners, a new study says.

The finding could prompt widespread concern, given that these painkillers -- known as nonsteroidal anti-inflammatory drugs (NSAIDs) -- and anti-clot medications are widely used by heart attack survivors, researchers said.

"For all sorts of reasons, many of us have been concerned about NSAIDs in a heart attack context for a long time," said Dr. Charles Campbell, chief of cardiovascular medicine at the University of Tennessee Erlanger Health Systems in Chattanooga. "For example, we know NSAIDs have an adverse effect on the kidney. And we have long worried that what this study has found was going to be the case."

There appeared to be no safe window period for taking an NSAID. Bleeding risk rose even within the first three days of NSAID use, the team noted in the Feb. 24 issue of JAMA.

"I would absolutely minimize your NSAID use if you're a patient in this category," Campbell said.

Many people use these nonsteroidal painkillers because of muscle discomfort and arthritis pain, said Campbell, co-author of an editorial accompanying the findings. "We can't just tell them to just suck it up. But we'll have to think about different solutions for these folks, because the NSAID risk is just too high," he added.

Common over-the-counter NSAIDs in the United States include ibuprofen (Advil, Motrin and Nuprin) and naproxen (Aleve and Naprosyn). Prescription options include diclofenac (Voltaren, Cambia) and the so-called COX-2 inhibitor drug celecoxib (Celebrex).

A team led by Dr. Anne-Marie Schjerning Olsen, of Copenhagen University Hospital in Denmark, examined NSAID use among roughly 62,000 Danish patients who survived a first heart attack between 2002 and 2011.

All were 30 and older (average age 68), and all had survived at least a month after hospital discharge. More than six in 10 were men.

Danish national hospital records revealed that all were on some form of anti-clotting treatment, such as aspirin or clopidogrel, following their heart attack.



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