Another Look at Nonsteroidal Anti-Inflammatory Drugs and Adverse Cardiovascular Events

Nonsteroidal anti-inflammatory drugs (NSAIDs) raise risk for adverse cardiovascular (CV) events, but several studies have suggested that naproxen might pose the least CV risk (NEJM JW Gen Med Aug 1 2006 and BMJ 2006; 332:1302; NEJM JW Gen Med Jul 15 2011 and Circulation 2011; 123:2226). In this nested case-control study (drawn from a U.K. database of 11 million patients), researchers examined associations between myocardial infarction (MI) and two commonly prescribed NSAIDs — diclofenac and naproxen — among patients with no MI history.

Among patients with osteoarthritis, current use of naproxen (i.e., most-recent prescription in the preceding 0–181 days) was not associated with MI (adjusted odds ratio, 0.98), but current use of diclofenac wa…