Cardiovascular risk associated with nonsteroidal anti-inflammatory drugs.
Since the introduction of selective cyclooxygenase-2 inhibitors (coxibs), there has been an ongoing discussion about the cardiovascular (CV) safety of coxibs and the traditional nonsteroidal anti-inflammatory drugs (NSAIDs). Available data about the CV safety of NSAIDs come mostly from meta-analyses and a few clinical trials. Current evidence suggests that NSAIDs may increase the risk of CV events. Naproxen might be associated with lower risk, but available data are not conclusive. Recent recommendations on the treatment of patients with NSAIDs favor the use of naproxen in patients with increased CV risk. Therefore, this review focuses on data about naproxen and examines CV risk with ibuprofen and non-naproxen NSAIDs. In addition, data about CV safety of paracetamol (acetaminophen) are presented.
Hermann
Matthias
M
Department of Cardiology, University Hospital Zürich, Zürich, Switzerland. mhermann@gmx.de
D000082:Acetaminophen / Q000009:adverse effects; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology; D016022:Case-Control Studies; D002986:Clinical Trials as Topic; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D006801:Humans; D015201:Meta-Analysis as Topic; D009288:Naproxen / Q000009:adverse effects; D018570:Risk Assessment; D012307:Risk Factors
D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D000082:Acetaminophen; D009288:Naproxen