Painkillers May Raise Risk of Dangerous Heart Flutter

TUESDAY July 5, 2011 -- A new study finds that painkillers widely used to treat inflammation are associated with an increased risk of atrial fibrillation, a heart rhythm disorder connected with a raised risk of stroke, heart failure and death.

Previous research has linked non-steroidal anti-inflammatory drugs (NSAIDs) and newer anti-inflammatory medications known as cox-2 inhibitors to an increased risk for heart attacks and strokes, but this is the first study to link the painkillers with atrial fibrillation.

Danish researchers looked at 32,602 patients who had a first diagnosis of atrial fibrillation between 1999 and 2008. Each of those patients was compared with 10 age and gender-matched controls from the general population in Denmark.

The results showed that use of these medications was associated with an increased risk of atrial fibrillation. The link was strongest among new users of the drugs, with a 70 percent increased risk for cox-2 inhibitors and a 40 percent increase in risk for non-selective NSAIDs.

The increased risk is equal to about seven extra cases of atrial fibrillation per 1,000 new users of cox-2 inhibitors and about four extra cases per 1,000 new users of non-selective NSAIDs, according to the researchers at Aarhus University Hospital.

They also found that the risk when starting treatment with cox-2 inhibitors seemed highest in older people and patients with chronic kidney disease or rheumatoid arthritis.

"Our study thus adds evidence that atrial fibrillation or flutter need to be added to the cardiovascular risks under consideration when prescribing NSAIDs," the researchers concluded.

"There is evidence that these medicines affected the heart, but [we] did not have evidence that it affected the rhythm of the heart. This study sheds light on another problem that we did not know with these medicines," Dr. Furqan Tejani, director of advanced cardiovascular imaging at SUNY Downstate Medical Center in New York City, said in a statement.

The study is published online in the July 4 issue of the BMJ.

The drugs do, indeed, have a checkered history.

In 2004, the blockbuster cox-2 inhibitor called Vioxx was pulled from the market because of its link to an increased risk of heart attack. In 2007, the American Heart Association warned doctors about the risk of giving NSAIDs to heart patients and recommended that these patients receive only the lowest dose and take the drugs for the shortest possible time.

In addition, a study published in the July 2010 issue of Circulation: Cardiovascular Quality and Outcomes found that healthy people who take NSAIDs to relieve minor aches and pains may be at increased risk of death from heart problems.

And a review of existing research this year found that NSAIDs taken to treat inflammation can boost the risk of heart attack, stroke or death. The researchers said their finding from the analysis of 31 clinical trials of NSAIDs suggest that a patient's cardiovascular risk needs to be assessed before being prescribed NSAIDs. That study appeared in the January issue of the BMJ.

More information

The American Academy of Family Physicians has more about atrial fibrillation.

Posted: July 2011


View comments

Hide
(web5)