Diclofenac and ibuprofen linked to significantly increased risk of cardiac arrest

Having studied data from nearly 30,000 patients with a history of cardiac arrest, researchers conclude that over-the-counter NSAIDs should only be available in pharmacies and at low doses and quantities.

Over the counter NSAIDS in UK store

Non-steroidal anti-inflammatory drugs (NSAIDs) have been associated with increased cardiovascular risk for the past ten years, but the link between NSAIDs and cardiac arrest specifically has not been examined.

To investigate, researchers used the Danish Cardiac Arrest Registry to identify 28,947 patients who had had an out-of-hospital cardiac arrest between 2001 and 2010. The data showed that 3,376 were treated with an NSAID up to 30 days before their cardiac arrest.

The results, published in the European Heart Journal: Cardiovascular Pharmacotherapy
[1]
(2017;356:100-107), also showed that the NSAID diclofenac was linked to a 50% increased risk of cardiac arrest (odds ratio [OR] 1.50, 95% confidence interval [CI] 1.23­–1.82) while ibuprofen was linked to a 31% increase in risk (OR 1.31, 95% CI 1.14–1.51).

The researchers say that any conclusions on causality should be made with caution but recommend that over-the-counter NSAIDs should only be available at pharmacies, in limited quantities and at low doses.

References

[1] Sondergaard K, Weeke P, Wissenberg M et al. Non-steroidal anti-inflammatory drug use is associated with increased risk of out-of-hospital cardiac arrest: a nationwide case-time-control study. Eur Heart J Cardiovasc Pharmacother 2017;356:100-107. doi: 10.1093/ehjcvp/pvw041

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Citation
Clinical Pharmacist, CP, April 2017, Vol 9, No 4;9(4):DOI:10.1211/PJ.2017.20202466