Safety of Nonsteroidal Antiinflammatory Drugs in Patients with Cardiovascular Disease

Nonsteroidal antiinflammatory drugs (NSAIDs) are used in the management of a variety of conditions, but their prevalence is likely underreported as a result of widespread availability and the perception that nonprescription therapies are unnecessary to report during medication history taking. Howeve...

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Bibliographic Details
Published in:Pharmacotherapy 2015-05, Vol.35 (5), p.520-535
Main Authors: Danelich, Ilya M., Wright, Sampaguita S., Lose, Jennifer M., Tefft, Brittany J., Cicci, Jonathan D., Reed, Brent N.
Format: Article
Language:English
Subjects:
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Anti-Inflammatory Agents, Non-Steroidal - pharmacology
Anticoagulants - adverse effects
Arthritis
Aspirin - adverse effects
Atrial Fibrillation - etiology
Atrial Fibrillation - physiopathology
bleeding
Blood Pressure - drug effects
cardiac surgery
Cardiovascular disease
Cardiovascular Diseases - etiology
Cardiovascular Diseases - physiopathology
Coronary Artery Disease - etiology
Coronary Artery Disease - physiopathology
Cyclooxygenase Inhibitors - adverse effects
Drug Interactions
Heart Failure - etiology
Heart Failure - physiopathology
Hemorrhage - chemically induced
Humans
Medical research
noncardiac surgery
nonsteroidal antiinflammatory drugs
Platelet Aggregation Inhibitors - adverse effects
Prescription drugs
Risk
Side effects
Stroke - etiology
Stroke - physiopathology
Surgical Procedures, Operative
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Summary:Nonsteroidal antiinflammatory drugs (NSAIDs) are used in the management of a variety of conditions, but their prevalence is likely underreported as a result of widespread availability and the perception that nonprescription therapies are unnecessary to report during medication history taking. However, NSAIDs are associated with a number of adverse effects, especially in patients with cardiovascular disease (CVD). Patients with CVD and comorbidities for which NSAIDs may provide symptomatic relief (e.g., osteoarthritis, rheumatoid arthritis) tend to be older, which places them at greater risk of harm. For these reasons, the use of NSAIDs in patients with CVD is a significant public health concern. An understanding of the risks associated with NSAIDs is critical for clinicians across practice settings. In this review, we detail the safety of NSAIDs in patients with CVD, provide recommendations on their use in specific disease states, and discuss therapeutic alternatives.
ISSN:0277-0008
1875-9114
DOI:10.1002/phar.1584