title: [Nonsteroid anti-inflammatory drugs (NSAID) and risk of cardiovascular events. Literature review and clinical implications].
abstract: Non steroid anti-inflammatory drugs (NSAIDs) are largely used for treatment of acute and chronic pain, even for long periods of time (months or years). While it is known that their use is frequently associated with gastrointestinal damage, including major bleedings from peptic ulcer, the risk of cardiovascular events related to NSAID has received much less attention. However, there is a large body of evidence showing that NSAIDs (both "traditional", such as diclofenac or indobufen, and selective cyclooxygenase inhibitors, COX-2) are associated with a significant increase of risk of cardiovascular events, both fatal and nonfatal. Consequently, several options have been proposed for the treatment of pain, including the use of analgesic drugs with different mechanisms of action, such as the opiates. Of interest, the Italian Drug Agency (AIFA) published a few years ago a warning (Nota 66) on the careful prescription of NSAIDs in patients with overt heart disease, such as coronary artery disease and heart failure. Aim of this paper is to present the current status of knowledge on the proper use of NSAIDs and other analgesic drugs in the management of acute and chronic pain.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Temporelli
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Zito
authors.forename: Roberto Franco
authors.initials: RF
authors.lastname: Pedretti
authors.forename: Franceso Iachini
authors.initials: FI
authors.lastname: Belisarii
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Putortí
authors.forename: Pompilio
authors.initials: P
authors.lastname: Faggiano
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D066126:Cardiotoxicity; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D006801:Humans; D010146:Pain / Q000188:drug therapy; D012306:Risk
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal