Heart Care

Pain Relievers May Raise Risk for 2nd Heart Attack

Taking nonsteroidal anti-inflammatory pain relievers after a heart attack may raise your risk for a second heart attack, even several years afterward, a new study says.

For the study, researchers at the University of Copenhagen collected data on almost 100,000 people who had had a heart attack between 1997 and 2009. They found that 44 percent of these people had filled at least one prescription for a nonsteroidal anti-inflammatory drug (NSAID).

Compared with people who did not use NSAIDs, people who took the painkillers had a 59 percent higher risk of dying from any cause within a year after their heart attack, and a 63 percent higher risk within five years, the researchers found.

Second heart attack

In addition, the risk of having another heart attack or dying from heart disease increased 30 percent within one year, and 41 percent after five years.

These findings were the same for men and women regardless of age and income, the researchers found, and the study also accounted for factors such as other illnesses or medications.

"These results support previous findings that NSAIDs have no apparent safe treatment window among patients with a [prior] heart attack," says lead researcher Anne-Marie Schjerning Olsen, M.D. "Long-term caution with use of NSAIDs is advised in all patients after a heart attack."

Since 2007, American Heart Association (AHA) guidelines have warned of the potential risk of NSAIDs in people with heart disease who have had a heart attack.

A cautious approach

"This study highlights that substantial caution is necessary when considering NSAIDs in patients after a heart attack, no matter how long ago the heart attack occurred," says Gregg Fonarow, M.D., a spokesman for the AHA.

People with a history of heart attack should talk with their doctor before taking NSAIDs, including those that are available over the counter, Dr. Fonarow says.

But he stresses that the findings don't apply to aspirin, which is usually given to patients after a heart attack. Even though aspirin is an NSAID, it still works as protective therapy.

The study was published in a recent issue of the journal Circulation.

Always talk with your health care provider to find out more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)

American Academy of Family Physicians - Pain Relievers: Understanding Your OTC Options

FDA - A Guide to Safe Use of Pain Medicine

FDA - The Benefits and Risks of Pain Relievers

November 2012

Use Caution with Pain Relievers

Keep the following precautions in mind when taking any over-the-counter (OTC) pain relievers:

  • Know the active ingredients in each product. Read the entire label.

  • Don't exceed the recommended dosage on the package. Be sure to read the label each time you take a product. Follow directions, check the active ingredient, read the warnings, and make sure you're not taking another product containing the same active ingredient on the same day.

Check with your doctor before taking OTC pain relievers if:

  • You drink more than two alcoholic beverages a day

  • You have asthma

  • You've recently had any kind of surgery or are about to have surgery

  • You're pregnant or are nursing a baby

  • You have ulcers, kidney or liver damage, high blood pressure, or bleeding disorders

  • You take any arthritis drug

OTC pain relievers are intended for short-term relief of symptoms - a maximum of three consecutive days for reducing fever, 10 days for pain relief. Call your doctor if symptoms persist and before using these medications long-term.

Always talk with your health care provider to find out more information.

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