The use of NSAIDs, commonly known as painkillers, including ibuprofen are already known to be associated with cardiovascular risk but a new study, published in the BMJ, showed for the first time a link between the drugs and atrial fibrillation or flutter (AF) also known as irregular heart rhythm.
Danish researchers examined the records of more than 32,000 patients who had a first diagnosis of AF between 1999 and 2009 and compared each to 10 randomly selected control patients.They found that patients starting treatment with non-aspirin NSAIDs had 40-70% increased risk of AF compared to non-users. New users of cox-2 inhibitors, the newer forms of the drugs, were associated with a 70% increased risk.
The lead author concluded that the overall increased risk was still low and patients taking these medicine should not stop them but should discuss the potential risks with doctor. One-off doses or short courses of over-the-counter-strength ibuprofen are still considered safe.
In an accompanying editorial, the author said doctors should be cautious when precribing NSAIDs to older people because of the higher risk of AF.
Critics say that this was a population-based case control study with many strengths, but the lack of data on the amount of NSAIDs taken by the patients, confounders, lifestyle factors etc. could have affected the results.
Source: Schmidt M, Christiansen CF, Mehnert F, et al. Non-steroidal anti-inflammatory drug use and risk of atrial fibrillation or flutter: population based case-control study. BMJ 2011; 343:d3450 ( open access)
Editorial : Gurwitz JH. NSAIDs and atrial fibrillation. BMJ 2011, 343: d2495 (open access)
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