Nonsteroid anti-inflammatory drugs (NSAID) and risk of cardiovascular events. Literature review and clinical implications

Submitted: August 21, 2015
Accepted: August 21, 2015
Published: August 21, 2015
Abstract Views: 2604
PDF: 1786
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Non steroid anti-inflammatory drugs (NSAIDs) are largely used for treatment of acute and chronic pain, even for long periods of time (months or years). While it is known that their use is frequently associated with gastrointestinal damage, including major bleedings from peptic ulcer, the risk of cardiovascular events related to NSAID has received much less attention. However, there is a large body of evidence showing that NSAIDs (both “traditionalâ€, such as diclofenac or indobufen, and selective cyclooxygenase inhibitors, COX-2) are associated with a significant increase of risk of cardiovascular events, both fatal and nonfatal. Consequently, several options have been proposed for the treatment of pain, including the use of analgesic drugs with different mechanisms of action, such as the opiates. Of interest, the Italian Drug Agency (AIFA) published a few years ago a warning (Nota 66) on the careful prescription of NSAIDs in patients with overt heart disease, such as coronary artery disease and heart failure. Aim of this paper is to present the current status of knowledge on the proper use of NSAIDs and other analgesic drugs in the management of acute and chronic pain.

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Temporelli, Pier Luigi, Giovanni Battista Zito, Roberto Franco Pedretti, Francesco Iachini Belisarii, Giuseppe Putortì, and Pompilio Faggiano. 2015. “Nonsteroid Anti-Inflammatory Drugs (NSAID) and Risk of Cardiovascular Events. Literature Review and Clinical Implications”. Monaldi Archives for Chest Disease 82 (3). https://doi.org/10.4081/monaldi.2014.58.