All five nonsteroidal anti-inflammatory drugs (NSAIDs) examined could raise the risk as early as the first week of use, an international team of researchers found.
They concluded that there was a greater than 90% probability that all the NSAIDs they studied were associated with a heightened risk of heart attack.
The overall odds of having a heart attack were about 20% to 50% greater if using NSAIDs compared with not using the drugs, although it varied for the individual drugs assessed, which also included naproxen, diclofenac, celecoxib and rofecoxib.
As it was an observational study, cause and effect could not be established conclusively.
Nevertheless the authors, led by Michèle Bally of the University of Montreal Hospital Research Centre, write: “Given that the onset of risk of acute myocardial infarction [heart attack) occurred in the first week and appeared greatest in the first month of treatment with higher doses, prescribers should consider weighing the risks and benefits of NSAIDs before instituting treatment, particularly for higher doses.”
Previous studies had suggested NSAIDs could increase the risk of heart damagebut the authors said the timing, the effect of dose, the treatment duration and the comparative risk between different types were poorly understood.
For the paper, published in the BMJ on Tuesday, the researchers analysed results on 446,763 people on healthcare databases in countries including Canada, Finland and the UK, of whom 61,460 had a heart attack.