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Short Term Use of Painkillers Could Be Dangerous to Heart Patients
ScienceDaily ^ | May 10, 2011 | NA

Posted on 05/11/2011 12:06:11 AM PDT by neverdem

Even short-term use of some painkillers could be dangerous for people who've had a heart attack, according to research published in Circulation: Journal of the American Heart Association.

Researchers analyzed the duration of prescription non-steroidal anti-inflammatory drugs (NSAIDs) treatment and cardiovascular risk in a nationwide Danish cohort of patients with prior heart attack. They found the use of NSAIDs was associated with a 45 percent increased risk of death or recurrent heart attack within as little as one week of treatment, and a 55 percent increased risk if treatment extended to three months.

The study was limited by its observational nature and the lack of clinical parameters, researchers said. NSAIDs are commonly used by the general population and are associated with increased cardiovascular risk in people with heart disease or those at high risk.

In a 2007 statement, the American Heart Association advised physicians about the risks of NSAID use among heart patients and provided a stepped care approach. In addition, the statement advised extra caution for when NSAIDs might be used, noting that they should "be limited to patients for whom there are not appropriate alternatives, and then, only in the lowest dose and for the shortest duration necessary."

In the current study, researchers undertook the first time-to-event analysis of a nationwide group and investigated if the duration of prescription NSAID treatment influenced the cardiovascular risk among heart patients. Among 83,697 heart attack survivors (average age 68; 63 percent men), 42.3 percent had a least one prescription for an NSAID.

The most common NSAIDs prescribed were ibuprofen (23 percent) and diclofenac (13.4 percent). Selective COX-2 inhibitors -- rofecoxib (4.7 percent) and celecoxib (4.8 percent) -- were also used.

The non-selective NSAID diclofenac was associated with early onset risk similar to the selective COX-2 inhibitor rofecoxib.

All NSAIDs were associated...

(Excerpt) Read more at sciencedaily.com ...


TOPICS: Culture/Society; News/Current Events; Testing
KEYWORDS: cad; chd; cox2; ibuprofen; medicine; nsaid; nsaids; paincontrol; painkiller; painmeds; pharmaceuticals; pharmeceuticals
Tylenol is not a NSAID.

Aspirin is the granddaddy of all NSAIDs. All of these patients, except those with an aspirin allergy, were probably prescribed at least a baby aspirin.

The presser links the abstract.

1 posted on 05/11/2011 12:06:15 AM PDT by neverdem
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To: neverdem

I’ve known for years that NSAIDS were bad news. Thankfully, my stomach doesn’t allow me to take them.


2 posted on 05/11/2011 12:37:25 AM PDT by South40 ("Islam has a long tradition of tolerance." ~Hussein Obama, June 4, 2009, Cairo, Egypt)
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To: neverdem

>> Aspirin is the granddaddy of all NSAIDs. All of these patients, except those with an aspirin allergy, were probably prescribed at least a baby aspirin.

This is confusing. Can you comment on the 81mg daily aspirin regiment prescribed for prevention?

The anti-inflammatory naproxen has some linkage to cardio problems, but baby aspirin?


3 posted on 05/11/2011 12:39:51 AM PDT by Gene Eric (*** Jesus ***)
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To: neverdem
I recently had a knee operation for a torn meniscus. The doctor gave me Hydrocodone for pain for 30 days. After the script ran out, I found I was back in pain. He gave me another MRI and found that my knee was torn again. He more or less said he wouldn't cut again until I needed a knee replacement. Well, what about the pain? I can't give you any more Vicodin, so here, try some Zip Zor. I read the side effects and there it was, about the 12th one down,...Can cause a heart attack or Tachycardia. I have high blood pressure and Tachycardia and take meds for it. He didn't care. NO MORE VICODIN! But Vicodin works fine and has no side effects for me. Well, you could get hooked and I have too many gubmint forms to fill out.

I took the Zip Zor and within a week I had to go to the ER to get my tachycardia to settle down. 4 hours of 200+ beats a minute was about to do me in. I stopped the Zip Zor. The next try was Mobic. No Vicodin. I had chest pains every day and nitro was the only relief. I stopped cold turkey. Now I sit in my Lazy Boy and use crutches to get to the bathroom. But at least I'm not hooked on drugs and no more tachycardia or chest pains. I just can't hardly walk. I wish I could get some Valium so I won't throw things at the TV, but he would have to fill out gubmint forms.

4 posted on 05/11/2011 12:40:54 AM PDT by chuckles
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To: chuckles

Vicodin is the only pain med that works for me. I have been on morphine while in the hospital and it did nothing for my broken femur, or when I had kidney stones. I was also recently prescribed a nsaid for neck pain following a car accident and after reading the side effects I refused to take it.


5 posted on 05/11/2011 12:43:42 AM PDT by LukeL (Barack Obama: Jimmy Carter 2 Electric Boogaloo)
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To: chuckles
P.S.

I told my Primary Dr this story and he recommended I get on an SSRI for depression. I said "Not a chance" I've seen people trying to get off SSRI's and it looks like someone on heroin. He said, What is it you have against doctors? I said, "I just told you!" I said, "Would you give me Vicodin?" He said that's up to your knee doctor.

These are America's best and brightest.

6 posted on 05/11/2011 12:46:41 AM PDT by chuckles
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To: chuckles

“These are America’s best and brightest.”

There isn’t a professional in the bunch, they are all practicing!


7 posted on 05/11/2011 1:01:00 AM PDT by dalereed
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To: neverdem

COX-2s have had this reported about them since day one. I convinced my mother to get off Celebrex for her back pain, but it wasn’t easy.


8 posted on 05/11/2011 1:11:21 AM PDT by buccaneer81 (ECOMCON)
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To: chuckles
I told my Primary Dr this story and he recommended I get on an SSRI for depression. I said "Not a chance" I've seen people trying to get off SSRI's and it looks like someone on heroin. He said, What is it you have against doctors? I said, "I just told you!" I said, "Would you give me Vicodin?" He said that's up to your knee doctor.

SSRI's to certain patients can be far more dangerous than Valium, Xanax, or similar Benzo tranquilizers. I have a bad back among several other medical issues and when it goes out {usually once a year for a few days} Hydrocodone works and I take it just a few days till I'm functional.

I've taken Xanax daily several times a day for 16 years though LOL. No one no doctor will ever get me to take an SSRI again nor especially have my wife to take them. I among amongst the ones who can not take them and so is my wife a 26 year Xanax user. We have first hand for ourselves seen what SSRI's can do to persons who have a severe adverse reaction to them. They too can kill you taken as directed but you'll not hear about it from most doctors.

9 posted on 05/11/2011 1:42:39 AM PDT by cva66snipe (Two Choices left for U.S. One Nation Under GOD or One Nation Under Judgment? Which one say ye?)
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To: neverdem

I’ve been prescribed 1000mg of Naproxen and 50mg of Tramadul for back pain so I think I will discontinue use for a few days to see if I can live without it.

Disturbing report.


10 posted on 05/11/2011 2:22:09 AM PDT by RetSignman ("It's about saving our Republic, STUPID")
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To: neverdem

If the article is correct, the study did not include asprin — which is obviously non-prescription.

“Researchers analyzed the duration of prescription non-steroidal anti-inflammatory drugs (NSAIDs)...”


11 posted on 05/11/2011 2:36:46 AM PDT by Da Mav
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To: chuckles
I have been suffering with back and knee pain since my army days.

Over the years, I have been prescribed many different pain medications and some of them have given me severe side effects and one medication, Indocin, even caused me to undergo surgery to correct the problems it caused.

NSAIDS in general caused me a lot of stomach pains and weren't very effective.

One medication Torodol, was extremely effective often stopping almost all pain within 15 minutes. I was on that for over four years. However, it has been linked to severe liver damage after one year and is no longer available in pill form even though hospitals still use in intravenously for some operations.

Darvon was completely ineffective and is now off the market due to the health problems it caused.

I was on Oxycontin for over a year but the Florida Hospital clinic didn't want to keep prescribing it for me once all the problems with Oxycontin abuse started.

Once I started with the VA clinic, Florida Hospital didn't want to bother with me any longer and was glad to get their Oxy prescription problem gone.

The VA doesn't use Oxycontin which is Oxycodone Continuous Release and uses Morphine Sustained Release instead which is much less effective for me. They finally after over five years admitted that they do use Oxycodone Immediate Release for ‘break through pain’ and I was finally able to get a prescription for that to go along with the Morphine.

I am finally getting some pain relief from the Morphine/Oxycodone combination but it took over five years of fighting with the VA clinic to get a prescribed dose which is finally providing some relief. The dose the VA is providing is still lower than what Florida Hospital was prescribing for Oxycontin alone.

I have been on narcotic pain relievers for many years now and other than the Torodol they are the only things that are effective for me.

Without exception, every NSAID that I have taken has caused me severe stomach or other problems and the only pain meds that don't cause me those problems are the opiate based pain relievers.

I do not abuse my meds and I am extremely carefiul to not overdose on any of them.
If one can avoid the narcotic addiction problem, the opiate pain relievers are the most compatible to one’s body pain relievers available.

12 posted on 05/11/2011 2:53:44 AM PDT by dglang
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To: neverdem

Do they know why these meds are bad? I glanced throught the article and didn’t see anything.


13 posted on 05/11/2011 3:06:07 AM PDT by Right Wing Assault (Our Constitution: the new Inconvenient Truth)
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To: LukeL
Vicodin is a combination of acetaminophen (Tylenol) and hydrocodone. The Hydrocodone (5 mg) is a much smaller dose than the acetaminophen at 500 mg.

The hydrocodone is much more effective than Morphine alone.
The acetaminophen is often added to other pain relievers to increase the effectiveness of the other medication while keeping the other medications dosage as low as possible.

The next step up from Vicodin would be Percocet which is acetaminophen and Oxycodone combined. The starting combination for both meds is 500 mg acetaminophen plus 5 mg of either Hydrocodone or Oxycodone.

14 posted on 05/11/2011 3:07:22 AM PDT by dglang
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To: LukeL
My wife was given Torodol for her pain when she had to go to the hospital for kidney pain.

Torodol used to be available in pill for and I was on It for over four years. It turns out that it does cause liver damage when used in pill form for over a year.

It is sill available and used in hospitals for injection.

It was very effective for my back pain usually stopping all pain in about 15 minutes.

It was originally created and marketed as an anti-inflammatory but it's pain relieving ability was so good doctors started prescribing it for pain alone.

15 posted on 05/11/2011 3:14:49 AM PDT by dglang
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To: Gene Eric
“This is confusing. Can you comment on the 81mg daily aspirin regiment prescribed for prevention?”

Although aspirin is indeed a non-steroidal anti-inflammatory drug, it is mechanistically distinct from ibuprofen, naproxen, and the COX-2 inhibitors. Aspirin is an effective platelet inhibitor and works to prevent clot formation in diseased unstable atherosclerotic plaques in your arteries.

16 posted on 05/11/2011 4:01:33 AM PDT by pieceofthepuzzle
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To: buccaneer81
COX-2s have had this reported about them since day one. I convinced my mother to get off Celebrex for her back pain, but it wasn’t easy.

That's because Celebrex works.

My doctor took me off Celebrex about six months ago because I have an inherited clotting factor (Factor V Leiden) and put me on 325mg Ecotrin. It doesn't do a thing for chronic pain so I sit longer, which is bad for clotting. Talk about a Catch 22.

I hope your mother finds something that will work. I can't take NSAIDS either and there are days Percocet just doesn't kick in.

And then there's the necessary headache meds to deal with FDA regulations for painkillers. Grrrrrr.....

17 posted on 05/11/2011 4:38:37 AM PDT by Kieri (The Conservatrarian)
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To: neverdem

I guess it’s come down to “pick your poison.”

Tylenol increases blood pressure

http://www.eplabdigest.com/content/Acetaminophen-can-increase-blood-pressure-cautions-Harvard-Heart-Letter


18 posted on 05/11/2011 4:45:37 AM PDT by dawn53
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To: All

Have Your Say Every Day.

Free Republic Runs ONLY On Your Donations.
Make Yours NOW and End the FReepathon!

19 posted on 05/11/2011 6:38:41 AM PDT by paulycy (Islamo-Marxism is Evil.)
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To: RetSignman

***I’ve been prescribed 1000mg of Naproxen ***

My mother asked her doctor for Napersen (Naproxen) for her arthritis. the Dr said he would have to monitor her kidneys closely as he really did not want her on Napersen but she insisted.

ONE dose of Naperson and it killed her kidneys dead. She died several months later of kidney failure and infection after lots of dialysis.

When she could not take dialysis anymore they used an intestinal wash but she got infected from it.

I stay far away from anything with Naperson in it.


20 posted on 05/11/2011 6:57:31 AM PDT by Ruy Dias de Bivar (Click my name. See my home page, if you dare!)
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To: Ruy Dias de Bivar

I was supposed to take 500mg of naproxen this AM after breakfast but I didn’t take it and won’t until I’ve talked to another doctor.


21 posted on 05/11/2011 7:10:52 AM PDT by RetSignman ("It's about saving our Republic, STUPID")
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To: Gene Eric; Da Mav; chuckles; LukeL; dalereed; buccaneer81; cva66snipe; RetSignman; dglang; ...
"Aspirin is the granddaddy of all NSAIDs. All of these patients, except those with an aspirin allergy, were probably prescribed at least a baby aspirin."

The first sentence in the presser:

"Even short-term use of some painkillers could be dangerous for people who've had a heart attack, according to research published in Circulation: Journal of the American Heart Association."

This is confusing. Can you comment on the 81mg daily aspirin regimen prescribed for prevention?

The anti-inflammatory naproxen has some linkage to cardio problems, but baby aspirin?

These folks already had a myocardial infarction, aka "heart attack." Unless they had an allergy to aspirin or another NSAID, they would be taking at least 81 milligrams of aspirin, aka a baby aspirn, for secondary prevention, i.e. to prevent another myocardial infarction. Otherwise, it's malpractice.

Primary prevention with a baby aspirin would be to prevent an initial myocardial infarction when there are enough risk factors, e.g. high blood pressure, diabetes, age, family history, etc.

Cyclooxygenase Inhibitors and the Antiplatelet Effects of Aspirin

Low-dose naproxen interferes with the antiplatelet effects of aspirin in healthy subjects: Recommendations to minimize the functional consequences

Aspirin irreversibly inhibits platelet aggregation. Other NSAIDs reversibly inhibit platelet aggregation, and so interfere with the job done by aspirin.

If you have chronic pain, consider Cobroxin. It's made from cobra toxin. It comes as an oral spray and topical gel. It's over the counter, so it's out of pocket. There are other non-opoiod drugs derived from natural sources in development, e.g. snail poison and a chemically modified marijuana with no psychoactive effects.

Bacteria Bite Back After Hospital Installs Innovative Faucets

Salmonella hits US teaching labs - Wave of infections triggers investigation into biosafety practices.

Beneficial Bacteria Help Repair Intestinal Injury by Inducing Reactive Oxygen Species

Vitamin D deficiency in pneumonia patients associated with increased mortality

FReepmail me if you want on or off my health and science ping list.

22 posted on 05/11/2011 8:07:00 PM PDT by neverdem (Xin loi minh oi)
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To: neverdem; DvdMom; grey_whiskers; Ladysmith; Roos_Girl; Silentgypsy; conservative cat; ...

Ping


23 posted on 05/11/2011 8:21:19 PM PDT by decimon
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To: neverdem

The clarification helped. Thanks.


24 posted on 05/11/2011 9:25:25 PM PDT by Gene Eric (*** Jesus ***)
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To: pieceofthepuzzle

>> Aspirin is an effective platelet inhibitor and works to prevent clot formation in diseased unstable atherosclerotic plaques in your arteries.

That was my understanding, but not exactly in those terms.


25 posted on 05/11/2011 9:27:23 PM PDT by Gene Eric (*** Jesus ***)
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To: neverdem

More and more I am coming to think that the standard clinical trial setup is worthless. Even the gold standard of double blind.

You simply cannot control all the variables. Some people say tomayto, others say tomahto.

There are a number of vids on Youtube lately that show how gene expression AMONGST IDENTICAL TWINS shows a large divergence as they age.

OTOH, I think there is good evidence that a few grams of HCN would not be good for most people...

:-)


26 posted on 05/12/2011 3:49:15 AM PDT by djf ("Life is never fair...And perhaps it is a good thing for most of us that it is not." Oscar Wilde)
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To: chuckles
If I ever get to the point of so much pain that my oral fairly high doses of Vit C and rubbing castor oil on the pain does not do the job, I am interested in trying intravenous Vit C for the pain.

It makes interesting reading to google it. I know of no one who has done it but from what I read it is very effective and instead of having undesirable side effects, it actually improves your health. I do know of a doctor within reasonable driving distance who does this.

27 posted on 05/12/2011 5:35:56 AM PDT by Conservativegreatgrandma
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To: decimon

I’m high risk per family history for CV disease. Prior to major abdominal surgery, I took 2400-3200 mg. ibuprofen for abdominal pain and headaches. After second major abd surgery, the surgeon prescribed IV ketorolac (sp?) or Toradol around the clock. I required no narcotics after that surgery and didn’t have an ileus, sepsis, or any of the other complications I had after the first surgery.
I’m old and have no aches or pains; no headaches, either.
It seems like there are a lot of factors involved here. I wouldn’t have been able to work had it not been for ibuprofen.
Now I don’t take pain meds.


28 posted on 05/12/2011 9:32:52 AM PDT by Silentgypsy
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To: neverdem

“prescription non-steroidal anti-inflammatory drugs (NSAIDs)”

Prescription generally means high doses, so the study seems more scary than it may be. You can get 200mg Ibuprofen OTC but the 800mg is only by prescription. Aspirin at 800mg is probably also by prescription, so I would take this study with a bit of caution concerning any blanket indictment of NASIDs other than at high dosages.


29 posted on 05/13/2011 3:50:38 AM PDT by KeyWest (Help stamp out taglines! They are obamanations.)
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