PEOPLE who have survived a heart attack seem to increase their risk of having another one, or of dying, by taking common painkillers called Non Steriodal Anti-Inflammatory Drugs (NSAIDs), a popular class of drugs that includes ibuprofen.
The unsettling link between non-steroidal anti-inflammatory drugs and heart attack risk is not new. The American Heart Association released guidelines in 2007 discouraging the use of any NSAIDs among people with a history of cardiovascular disease. Researchers in Denmark now bolster that link with the largest study to date of NSAID use in heart patients. The findings appear September 10 in Circulation.
In conducting the analysis, the scientists mined a huge database to identify every first-time heart attack in people 30 years old or older that occurred in the country between 1997 and 2009, nearly 100,000 people in all. The researchers then cross-checked this information with death records, subsequent heart attacks and NSAID prescriptions. (Most NSAIDs in Denmark are prescribed.) About 44 percent of people were prescribed an NSAID during the five years following a first heart attack.
Compared with people who didn’t get NSAIDs via prescription, those who did were 63 percent more likely to die over the next five years and 41 percent more likely to die specifically of a heart problem or to have another heart attack.
Also, many people have had a heart attack and don’t know it. A study of older people in Iceland finds that nearly twice as many had experienced a silent heart attack as had suffered one with all the medical bells and whistles. MRI scans revealed the hidden heart attacks better than standard testing by electrocardiography, or EKG, scientists report in the September 5 Journal of the American Medical Association.
It is helpful to know who has had a heart attack because for the long term such people are treated more aggressively with medication, says study coauthor Andrew Arai, a cardiologist at the National Heart, Lung, and Blood Institute in Bethesda, Md.
Arai and his U.S. colleagues teamed with Icelandic researchers to test 670 people who were randomly selected from Iceland’s population and 266 others chosen because they had diabetes. The overall median age of the volunteers was 76. Medical records showed that 91 had experienced a previous heart attack. But testing with MRI revealed that 157 others, including 72 who had diabetes, had clear signs of cardiac tissue that was damaged at some point in a silent heart attack. EKG spotted 46 such cases, including 15 patients with diabetes. Some people, but not all, were detected by both diagnostic tests.
