Initiating Diclofenac Is Associated with Excess Cardiovascular Risk

Diclofenac is a commonly prescribed traditional nonsteroidal anti-inflammatory drug (NSAID) that targets mainly cyclooxygenase (COX)-2, similar to celecoxib and rofecoxib, which have been associated with excess cardiovascular (CV) risk. Indeed, evidence suggests that diclofenac also is associated with excess CV risk (NEJM JW Gen Med Sep 15 2018 and Ann Rheum Dis 2018; 77:1137). In this study, Danish researchers used a national propensity-matched patient registry to compare rates of major adverse CV events (i.e., a composite of cardiac-related death, myocardial infarction [MI], ischemic stroke, heart failure, and atrial fibrillation) after initiation of diclofenac, other NSAIDs, or acetaminophen.

Within 30 days of drug initiation, major adver…