Safety of NSAID use among patients with cardiovascular diseases
ARTICLE PDF (Русский)

Keywords

nonsteroidal anti-inflammatory drugs, vascular comorbidity, pain treatment, high risk of complications, adverse gastrointestinal complications, cardiovascular safety

How to Cite

Svyrydova, N. (2018). Safety of NSAID use among patients with cardiovascular diseases. East European Journal of Neurology, (6(18), 11-15. https://doi.org/10.33444/2411-5797.2017.6(18).11-15

Abstract

Today, in medical practice, the number of patients who for a long time with the development of acute or chronic pain syndrome are forced to use non-steroidal anti-inflammatory drugs (NSAIDs) is steadily growing. At present, the problem of the relative cardiovascular safety of NSAID use is topical, which causes serious concern in the treatment of patients with severe vascular comorbidity. The safe use of NSAIDs, especially among elderly patients who may be at high risk for CVD or adverse gastrointestinal (GI) complications, is a constant problem for the doctor. Although the results of PRECISION provide an overview of the overall safety of these NSAIDs, the conclusions about the relative safety of celecoxib, naproxen and ibuprofen are complex and represent remaining gaps in knowledge. In a low-risk population in which the majority of patients received treatment for risk reduction, the data indicate that short-term CRs associated with all three drugs are really low and similar. There remains an open question about the effect of the duration of treatment and the dose of NSAIDs on the risk of cardiovascular disease. The meta-analysis did not reveal an increased risk of NSAIDs when used for less than 30 days or less than in full doses. It is recommended to evaluate the use of NSAIDs in patients based on individual risk factors to optimize the balance between anti-inflammatory and potential adverse events.

https://doi.org/10.33444/2411-5797.2017.6(18).11-15
ARTICLE PDF (Русский)

References

1. Pepine C. J., Gurbel P. A. (2017) Cardiovascular safety of NSAIDs: Additional insights after PRECISION and point of view. Clinical Cardiology. no 1.
2. Bally M, Dendukuri N, Rich B, et al. (2017) Risk of acute myocardial infarction with NSAIDs in real world use: Bayesian meta-analysis of individual patient data. BMJ, no 357, pp.190-199.
3. Kirkby NS, Lundberg MH, Harrington LS, et al. (2012) Cyclooxygenase-1, not cyclooxygenase-2, is responsible for physiological production of prostacyclin in the cardiovascular system. Proc Natl Acad Sci U S A, no 109, pp.17597–17602.
4. Yu Y., Ricciotti E., Scalia R., et al. (2012) Vascular COX-2 modulates blood pressure and thrombosis in mice. Sci Transl Med, no 4, pp.132-154.
5. Majed BH, Khalil RA. (2012) Molecular mechanisms regulating the vascular prostacyclin pathways and their adaptation during pregnancy and in the newborn. Pharmacol, no 64, pp.540–582.
6. Zarraga IG, Schwarz ER (2007) Coxibs and heart disease: what we have learned and what else we need to know. J Am Coll Cardiol, no 49, pp.1–14.
7. Wallace JL. (2008) Prostaglandins, NSAIDs, and gastric mucosal protection: why doesn't the stomach digest itself? Physiol, no 88, pp.1547–1565.
8. García Rodríguez LA, Tacconelli S, Patrignani P (2008) Role of dose potency in the prediction of risk of myocardial infarction associated with nonsteroidal anti-inflammatory drugs in the general population. J Am Coll Cardiol, no 52, pp.1628–1636.
9. Ghosh R, Alajbegovic A, Gomes AV. (2015) NSAIDs and cardiovascular diseases: role of reactive oxygen species. Oxid Med Cell Longev. no 536962.
10. Nissen SE, Yeomans ND, Solomon DH, et al. (2016) PRECISION Trial Investigators. Cardiovascular safety of celecoxib, naproxen, or ibuprofen for arthritis. N Engl J Med, no 375, pp.2519–2529.
11. Amsterdam EA, Wenger NK, Brindis RG, et al. (2014) Coronary Syndromes: a report of the American College of Cardiology American College of Cardiology; American Heart Association Task Force on Practice Guidelines; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons; American Association for Clinical Chemistry. 2014 AHA/ACC Guideline for the Management of Patients with Non–ST-ElevationAmerican Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol, no 64, pp.2713–2714
12. Chenggui Zhang, Guodong Wang, Xiaoyang Liu. (2017) Safety of continuing aspirin therapy during spinal surgery: а systematic review and meta-analysis. Medicine (Baltimore), no 96(46), pp.8603.
13. Hall R, Mazer CD. (2011) Antiplatelet drugs: a review of their pharmacology and management in the perioperative period. Anesth Analg, no 112, pp.292–318.
14. Macchi L, Sorel N, Christiaens L. (2006) Aspirin resistance: definitions, mechanisms, prevalence, and clinical significance. Curr Pharm Des, no 12, pp.251–8.
15. Park HJ, Kwon KY, Woo JH. (2014) Comparison of blood loss according to use of aspirin in lumbar fusion patients. Eur Spine J, no 23, pp.1777–82
16. Oscarsson A, Gupta A, Fredrikson M, et al. (2010) To continue or discontinue aspirin in the perioperative period: a randomized, controlled clinical trial. Br J Anaesth, no 104, pp.305–12
17. Park JH, Ahn Y, Choi BS, et al. (2013) Antithrombotic effects of aspirin on 1- or 2-level lumbar spinal fusion surgery: a comparison between 2 groups discontinuing aspirin use before and after 7 days prior to surgery. Spine (Phila Pa 1976), no 38, pp. 1561–5.
18. Solomon D.H., Husni M.E., Wolski K.E., Wisniewski L.M. (2017) Differences in Safety of Non-Steroidal Anti-Inflammatory Drugs in Patients with Osteoarthritis and Rheumatoid Arthritis: A Randomized Clinical Trial. Arthritis Rheumatol, pp.404-20
19. Bronnum-Hansen H, Davidsen M, Thorvaldsen P. (2001) Long-term survival and cause of death after stroke. Stroke, no 32, pp.2131–6.
20. Kernan WN, Viscoli CM, Brass LM, Makuch RW, Sarrel PM, Roberts RS, et al. (2000) The Stroke Prognosis Instrument II (SPI-II): a clinical prediction instrument for patients with transient ischemic and non-disabling ischemic stroke. Stroke, no 31, pp.456–62.
21. Kleindorfer D, Panagos P, Pancioli A, Khoury J, Kissela B, Woo D, et al. (2005) Incidence and short-term prognosis of transient ischemic attack in a population-based study. Stroke, no 36, pp.720–3.
22. Lafeber M, Spiering W, van der Graaf Y, Nathoe H, Bots ML, Grobbee DE, et al. (2013) The combined use of aspirin, a statin, and blood pressure-lowering agents (polypill components) and the risk of vascular morbidity and mortality in patients with coronary artery disease. Am Heart J, no 166, pp.282–9.
23. Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI, Ezekowitz MD, et al. (2014) Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association / // American Stroke Association. Stroke, no 45(7), pp.2160–236.
24. Svyrydova N.K., Sereda V.H., Popov O.V., Pavliuk N.P., Usovych K.M., Svystun V.Iu. (2015) Deheneratyvno-dystrofichni zakhvoriuvannia khrebta: osoblyvosti diahnostyky ta likuvannia. [Degenerative-dystrophic diseases of the spine features diagnostics and treatment]. Skhidno-yevropeiskyi nevrolohichnyi zhurnal. no 2, pp. 14-26
https://scholar.google.com.ua/citationsuser=M0m9l3gAAAAJ&hl=uk#d=gs_md_citad&p=&u=%2Fcitations%3Fview_op%3Dview_citation%26hl%3Duk%26user%3DM0m9l3gAAAAJ%26citation_for_view%3DM0m9l3gAAAAJ%3AYsMSGLbcyi4C%26tzom%3D-120 [in Ukrainian]
25. Murashko N.K., Kustkova H.S. (2010). Diahnostychne znachennia tsyrkadnykh rytmiv pry hipertenzyvnii entsefalopatii u khvorykh z kryzovymy stanamy hipertonichnoi khvoroby. [Diagnostic value of circadian rhythms in hypertensive encephalopathy in patients with crisis conditions of hypertensive disease] Medychni perspektyvy, no 15.4.
https://scholar.google.com.ua/citationsuser=M0m9l3gAAAAJ&hl=uk#d=gs_md_citad&p=&u=%2Fcitations%3Fview_op%3Dview_citation%26hl%3Duk%26user%3DM0m9l3gAAAAJ%26citation_for_view%3DM0m9l3gAAAAJ%3AeflP2zaiRacC%26tzom%3D-120