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Increased risk of cardiac arrest with commonly used non-steroidal anti-inflammatory drugs.

The non-steroidal anti-inflammatory drugs (NSAIDs) diclofenac and ibuprofen are associated with a significantly inreased risk of cardiac arrest, according to a Danish study published in the European Heart Journal: Cardiovascular Pharmacotherapy.

Researchers used the Danish Cardiac Arrest Registry to identify all individuals who had a cardiac arrest out of hospital between 2001 and 2010. Of the 28 947 people identified, 3 376 had been treated with an NSAID up to 30 days before their cardiac arrest. Each case was matched with four controls from the Danish Patient Registry.

Ibuprofen and diclofenac were the most commonly used NSAIDs, representing 51% and 22% of total NSAID use, respectively. The study found that use of any NSAID was associated with a 31% increased risk of cardiac arrest. Diclofenac was associated with a 50% increased risk of cardiac arrest (odds ratio (OR) 1.50, 95% confidence interval (CI) 1.23-1.82), and ibuprofen was associated with a 31% increased risk (OR 1.31, 95% CI 1.14-1.51).

The study found no significant association between cardiac arrest and the COX-2 selective inhibitors celecoxib and rofecoxib, or with the unselective NSAID naproxen. However, these drugs are rarely used in Denmark so relatively few events occurred, leading to low statistical power.

The authors say that the study is a stark reminder that NSAIDs are not harmless and should not be used without advice from a healthcare professional.

Sondergaard K, Weeke P, Wissenberg M, et al. Non-steroidal anti-inflammatory drug use is associated with increased risk of out-of-hospital cardiac arrest: A nationwide case-time-control study. Eur Heart J Cardiovasc Pharmacother 2017; 3(2):100-107.

B Farham


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Title Annotation:30 days in medicine
Author:Farham, B.
Publication:South African Medical Journal
Article Type:Report
Date:May 1, 2017
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