NSAIDs and Your Heart

Neck-PainPain relief is an important part of maintaining quality of life for many, including me, so NSAIDs, non-steroidal anti-inflammatory medicines, are welcome.  But many studies have rumbled that they may be risky for your heart.  Good news then, as Rick and I discuss on PodMed this week and as published online in NEJM, at least three of them appear NOT to confer increased risk for cardiovascular events, at least in comparison to each other and with certain other caveats.  This as also revealed at the recently concluded American Heart Association meeting.

People who took part in this trial had either osteo- or rheumatoid arthritis and were randomized to either celecoxib (Celebrex), ibuprofen or naproxen at various doses daily. Just over 24,000 subjects were treated for about two years and followed for almost three. Almost 70% of participants stopped taking their drug and just over 27% discontinued follow-up. When looking for the three primary outcomes of cardiovascular death, nonfatal heart attack or stroke, no significant difference was found between the three groups, with about 2.5% experiencing such an event. Additional assessments were also made with regard to renal and gastrointestinal problems, with celecoxib emerging as the least risky.

Rick concludes from this study that at the low doses employed here, and for short duration, celecoxib appears to be safe, but we'd both like to see a more pragmatic trial with higher doses and longer treatment periods. Other topics this week include Randomized Trial of Bilateral versus Single Internal-Thoracic-Artery GraftsGenetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease, and A Highly Durable RNAi Therapeutic Inhibitor of PCSK9. Until next week, y'all live well.

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