Editorials

NSAIDs and the failing heart

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i5163 (Published 28 September 2016) Cite this as: BMJ 2016;354:i5163
  1. Gunnar H Gislason, professor of cardiology1 2 3,
  2. Christian Torp-Pedersen, professor of cardiology4
  1. 1Cardiovascular Research Centre, Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, 2900 Hellerup, Denmark
  2. 2National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
  3. 3Danish Heart Foundation, Copenhagen, Denmark
  4. 4Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
  1. Correspondence to: G H Gislason gg{at}heart.dk

NSAIDs pose a clear risk to some patients and tighter regulation is justified

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used drugs and are mainly used to alleviate pain and inflammation. NSAIDs were first introduced over a century ago and most of the commonly used NSAIDs were registered in an era with few requirements for safety documentation. Therefore, for most of these drugs, there is an alarming lack of randomised studies addressing their safety. With the introduction of selective cyclo-oxygenase (COX) 2 inhibitors, concerns were raised that unbalanced COX 2 inhibition might increase cardiovascular risk.1 This has been demonstrated in several randomised and observational studies, and further warning flags have been raised about the cardiovascular safety of non-selective NSAIDs.2 3 4 5 6 7

Arfé and colleagues8 present results from a nested case-control study based on real world data from four European countries and almost 10 million NSAID …

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