Painkillers Bad for Heart

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Painkillers Bad for Heart

Do Painkillers Affect Heart Equally?


Analysis Takes New Look at Heart Attack Risk of Popular Painkillers

June 1, 2006 - A new analysis shows that some popular nonsteroidal pain killers are just as likely to increase the risk of heart attacks as the Cox-2 inhibitors, two of which were removed from the market.

Researchers described the risk as "modest" for people who do not already have heart or vascular disease.

Prior to the fall of 2004, three Cox-2 inhibitors -- Vioxx, Celebrex, and Bextra -- were sold by prescription in the U.S. The Cox-2 inhibitors are a newer type of nonsteroidal painkiller. They were considered safer than traditional nonsteroidal anti-inflammatory (NSAID) pain relievers because of a lower risk for stomach bleeding and ulcers.

But concerns about heart attackand stroke risk led to the removal of Vioxx and Bextra from the market. Only Celebrex remains.

There is still widespread confusion about just how risky these drugs really are, compared with traditional NSAIDs.

Absolute Risk 'Small'


Researchers from the United Kingdom and Italy combined data from 138 clinical trials involving 140,000 patients in an effort to give a more comprehensive picture of risk than has been previously available.

Their findings are published in the June 3 issue of the BMJ (British Medical Journal).

As expected, Cox-2 inhibitors were associated with an increased risk of vascular events, mostly due to a twofold increase in heart attack risk among users.

But researcher Colin Baigent, MD, of the University of Oxford in England, tells WebMD that the absolute risk for people without pre-existing cardiovascular disease is relatively small. Risk among people with heart and vascular disease could not be assessed because they are generally excluded from clinical trials.

Cox-2 inhibitor use was associated with roughly three additional heart attacks or other vascular events each year for every 1,000 users.

The degree of risk is similar to that seen with regular aspirin or nonsteroidal pain reliever use and bleeding stomach ulcers, Baigent says.

"These risks must be kept in perspective," he adds. "In an absolute sense they can be considered modest and comparable to the sorts of risks that we deal with every day with other commonly used drugs."
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