Risk of nonfatal acute myocardial infarction associated with non-steroidal antiinflammatory drugs, non-narcotic analgesics and other drugs used in osteoarthritis: a nested case-control study

Abstract

The risk of nonfatal AMI varied with individual tNSAIDs, duration of treatment and background cardiovascular risk. Paracetamol, metamizole and SYSADOAs did not increase the risk in any of the conditions examined.

Non-steroidal anti-inflammatory drugs and risk of cerebrovascular events in patients with osteoarthritis: a nested case–control study

“…To date, several studies demonstrate the causal relationship between NSAIDs and ischemic cardiomyopathy [6,8,28]. Nevertheless, few investigations have focused on cerebrovascular events [9][10][11]29].…”

“…This review shows a consistent but small increase in the risk of cardiovascular side effects for diclofenac compared to other traditional NSAIDs, which is similar to the risk of rofecoxib [5]. However, most of the previous studies were focused on ischemic cardiomyopathy or composite outcomes of ischemic cardiomyopathy, stroke or heart failure [6][7][8]. On the other hand, the evidence is scarce for an association between NSAIDs, especially for individual molecules, and the risk of ischemic stroke/transient ischemic attack (TIA) or hemorrhagic stroke [9][10][11].…”

Paracetamol, Ibuprofen, and Recurrent Major Cardiovascular and Major Bleeding Events in 19 120 Patients With Recent Ischemic Stroke

“…Paracetamol intake was not associated with an increase in stroke rate in a recent population-based case-control study, nor to myocardial infarction in other studies. [12][13][14] In an acute stroke setting, paracetamol treatment to control mildto-moderate hyperthermia (37-39°C) seemed to be associated with a better final outcome, reducing disability at 3 months according to the modified Rankin scale. 15 Although there is a more commonly accepted belief that other NSAIDs, such as ibuprofen, have a higher vascular risk, there are still conflicting data in the literature.…”

“…Although some authors claim that ibuprofen intake is associated with an increase in vascular risk, 16 others have found no such association. 12,13 NSAIDs-associated bleeding risk is well known, particularly of a gastrointestinal origin. 16 Their use represents an independent risk factor in patients with an antithrombotic treatment, even when prescribed for a short term.…”

Paracetamol, one of the most dangerous compounds in medical use?

“…. .myocardial infarction": Cited is a study by Chan et al (2006), which reported an elevated risk for use of paracetamol on ≥22 days per month, but not that by Rosenberg et al (2003), which rather pointed to a protective effect, and the case-control study by de Abajo et al (2014), in which NSAIDs, but not paracetamol, were associated with a risk for acute myocardial infarction.…”