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Commonly used NSAID painkillers may be deadly for first-time heart attack sufferers

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Ibuprofen pills. istockphoto

(CBS News) Heart attack survivors who take commonly used painkillers may be at a greater risk of having a second heart attack or worse - an early death.

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A new study in the American Heart Association's Journal, Circulation, raises concern about taking non-steroidal anti-inflammatory drugs (NSAIDs). Such drugs include the over-the-counter pills ibuprofen (Advil, Motrin), naproxen (Aleve) and prescriptions such as Celebrex (celecoxib).

Researchers from Copenhagen University Hospital Gentofte in Denmark looked at 100,000 Danes who were 30 and older who had a first heart attack between 1997 and 2009 to see if they had been prescribed an NSAID afterwards.

The researchers found that 54 percent of heart attack sufferers filled at least one prescription for an NSAID. Those people were 30 percent more likely to have another heart attack or die from coronary artery disease within one year of their first heart attack, compared to people who weren't. Risk rose to a 41 percent higher chance of heart attack and heart disease death after five years.

People who were prescribed the anti-inflammatory pain pill were 59 percent more likely to die from any cause one year after their first heart attack, compared with those who weren't prescribed the drug. Death risk persisted even five years after the first heart attack with a 63 percent greater likelihood of dying compared to people who weren't taking an NSAID.

There were no differences in results between men and women or certain age groups or household income statuses. The study however was observational and did not definitely show NSAIDs caused these deaths. However the researchers think the pills may be to blame and questioned the drugs over-the-counter availability.

"The results support previous findings suggesting that NSAIDs have no apparent safe treatment window among heart attack patients, and show that coronary risk related to using the drugs remains high, regardless of the time that has passed since the heart attack," study author Dr. Schjerning Olsen, a fellow in the cardiology department at Copenhagen University Hospital Gentofte, said in a press release.

A 2007 statement from the American Heart Association urged doctors to carefully weigh the risks versus the benefits when prescribing an NSAID to patients with a history or high risk of heart disease.

Dr. Gordon Tomaselli, immediate past president of the American Heart Association who directs the division of cardiology at Johns Hopkins University School of Medicine in Baltimore, told WebMD, "Patients who do take NSAIDs should always use the lowest dose possible to control pain for the shortest duration."

"It's always a good idea to make sure you understand what your medication is for and are aware of any possible side effects," added Maureen Talbot, a senior cardiac nurse at the British Heart Foundation, to The Telegraph. "If you've had a heart attack, make sure you have a chat with your doctor before taking any extra tablets."

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