Widely used pain relievers may increase the risk of a heart attack when used during a cold or flu-like illness, according to a new study published in the Journal of Infectious Diseases. The findings suggest physicians and patients should use caution when prescribing or taking the medications, known as nonsteroidal anti-inflammatory drugs, or NSAIDs, to ease symptoms of acute respiratory infections.
In an observational study, researchers analyzed claims from Taiwan’s National Health Insurance Program over a seven-year period (2005-2011), including data from nearly 10,000 patients who were hospitalized for a heart attack. The goal was to investigate whether two potential cardiac risk factors–an acute respiratory infection, such as a cold or influenza, and NSAID use–have a combined, joint effect on heart attack risk.
The researchers compared each patients’ own risk for heart attack over time, across episodes of respiratory illness and NSAID use. They found a stronger association with a heart attack when both risk factors were present. Using the pain relievers during an acute respiratory infection was associated with a 3.4-fold increased risk for a heart attack, with7.2 times greater risk when patients received the pain-relieving medication intravenously in the hospital, compared to times when patients had neither of the risk factors.
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The heart attack risk when patients with an acute respiratory illness were not taking an NSAID was 2.7 times greater, while the risk was 1.5 times greater when individuals took the drugs and did not have an infection. Previous research has implicated respiratory infections and some NSAIDs as potential triggers for heart problems, but earlier studies have examined these risk factors only separately.
“Physicians should be aware that the use of NSAIDs during an acute respiratory infection might further increase the risk of a heart attack,” said study author Cheng-Chung Fang, MD, of National Taiwan University Hospital.
