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Title: Naproxen Associated With Reduced Heart Attack Risk

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Archives of Internal Medicine, 2002; 162: 1099-1104.
05/27/2002 09:02:57 AM
By Elda Hauschildt

Use of naproxen, a non-steroidal anti-inflammatory drug (NSAID), has been associated with reduced risk of heart attack. Naproxen was associated with an apparent 16 to 20 percent reduction in AMI risk in a case-control study of AMI using information from a large United States health-care database. Researchers from Brigham and Women's Hospital, Harvard Medical School in Boston, Massachusetts, point out that aspirin has long been shown to protect patients against acute myocardial infarction (AMI). They found use of most other NSAIDs does not. "Although NSAIDs have anti-inflammatory and anti-platelet effects similar to those of aspirin, we do not find that these drugs confer a protective effect against AMI," say investigators led by Dr. Daniel H. Solomon. However, "use of one specific NSAID, naproxen, appeared to be associated with a reduced rate of AMI, an effect recently suggested by a large, randomised controlled trial as well." The investigators suggest there are substantial clinical implications if these findings are confirmed in other populations. It means patients who regularly use most NSAIDs also require the cardio-protective effect of aspirin. Information was accessed on all filled prescriptions, hospitalisations, diagnoses and procedures for all patients covered in the New Jersey Medicaid or Medicare and Pharmaceutical Assistance for the Aged and Disabled programs. The researchers identified 4,425 AMI patients hospitalised between January 1991 and December 1995 as well s 17,700 control subjects. Twenty-five percent of case patients and controls had filled a NSAID prescription in the six months before an AMI (for case patients) or a randomly assigned index date (for controls). As well, 9 percent of case patients and controls had filled a NSAID prescription overlapping with the AMI or index date. "Overall, NSAID users had the same risk of AMI as non-users, whether such use was measured on the index date or at any time in the prior six months," the researchers explain. They say use of naproxen was associated with a significant reduction in the risk of AMI. Adjusted odds ratio for naproxen was 0.84.

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