Anti-inflammatories tied to cardiac risk

ScienceNews ^ | September 10th, 2012 | Nathan Seppa

[neverdem]

Heart attack survivors using certain painkillers are more likely to die or suffer another event

People who have survived a heart attack seem to increase their risk of having another one, or of dying, by taking common painkillers called NSAIDs, a popular class of drugs that includes ibuprofen.

The unsettling link between non-steroidal anti-inflammatory drugs and heart attack risk is not new. The American Heart Association released guidelines in 2007 discouraging the use of any NSAIDs among people with a history of cardiovascular disease. Researchers in Denmark now bolster that link with the largest study to date of NSAID use in heart patients. The findings appear September 10 in Circulation.

In conducting the analysis, the scientists mined a huge database...

--snip--

Strand says the researchers have compiled “very impressive data.” But she notes that the researchers were unable to track use of aspirin, which is sold over the counter in Denmark. Daily low-dose aspirin limits heart attacks by reducing the blood’s clotting ability. “If you don’t take aspirin regularly, or if you take it simultaneously with NSAIDs, you lose that aspirin benefit,” Strand says. NSAIDs bind to the same molecular pocket on blood platelets as aspirin does, crowding out the aspirin. While NSAIDs have some ability to limit clotting caused by platelet aggregation, this capacity fades as the drugs wear off, she notes. In contrast, when aspirin binds to a platelet, its effect is irreversible, which is how daily aspirin suppresses stickiness in the population of platelets even as they are replenished.

“Some people think that if they are taking NSAIDs, they don’t need aspirin,” Strand says. “That’s absolutely wrong.” Patients who need NSAIDs for pain or inflammation, yet who have risk factors for heart disease, should take aspirin at least a few hours before taking an NSAID, she says...

[neverdem]

Old news, but it's worth repeating. You can link the abstract in the right sidebar.

[donna]

I thought aspirin was an NSAID.

[Nervous Tick]

Depressing... you know, the more I read about how everything we do, or eat, or take is bad for us, and everything we don’t do, or don’t eat, or don’t take is vital for our survival... I start to get the feeling that we’re all gonna die someday. :-)

[Johnny_cash]

^^ LOL ^^

[Rokurota]

The article is a little confusing. Aspirin is an NSAID. The article makes it sound like it isn’t.

[TheRhinelander]

So take curcumin instead. Widely available or just eat a lot of tumeric.

Inflammation causes a lot of internal problems including alzheimers and all sorts of other nasty stuff.

[Nervous Tick]

In conducting the analysis, the scientists mined a huge database...

Miners face health risks, even on good days. :-)

[zeestephen]

My aspirin label says NSAID.

I take one every day.

So, now we have “good” NSAID and “bad” NSAID?

[Fractal Trader]

I recently read an expert source that suggested that the benefits of aspirin were so mild that these benefits were countered by the increased risks of bleeding and such that are known to be associated with aspirin use.

[neverdem]

It’s time to get serious about science

Organic food benefits questioned in study

Vaccine trial reveals chinks in HIV's armour

High Doses of Vitamin D Help Tuberculosis Patients Recover More Quickly

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

[bert]

I take one 325 mg tablet per day per Dr’s orders. In addition to the blood thinning capability, which is real, the total benefits are not known. The anti inflammatory properties are beneficial in preventing arterial inflammation and associated platet clogging.

Additionally, I carry a small Altoids tin with two 325 mg aspirin tablets to be chewed at the first indication of heart attack or stroke. It is my cardiac first aid kit. I never leave home with out it.

[Main Street]

“I’m not gonna worry wrinkles in my brow

‘Cause nothin’s ever gonna be alright nohow

No matter how I struggle and strive

I’ll never get out of this world alive”

- Hank Williams

[neverdem]

"While NSAIDs have some ability to limit clotting caused by platelet aggregation, this capacity fades as the drugs wear off, she notes. In contrast, when aspirin binds to a platelet, its effect is irreversible, which is how daily aspirin suppresses stickiness in the population of platelets even as they are replenished."

I thought aspirin was an NSAID.

Aspirin is the granddaddy of modern NSAIDS. It does its trick by irreversibly inhibiting platelet aggregation.

The other NSAIDS reversibly inhibit platelet aggregation. That's why aspirin should be taken a few hours before any other NSAIDs for your aches and pains.

[Myrddin]

Method of action by aspirin

[John S Mosby]

“I don’t worry about a thing, ‘cause I know NOTHIN’s gonna be alright”
— Mose Allison

[Right Wing Assault]

Acetaminophen does not interfere with aspirin’s anti-clotting properties. It is NOT an NSAID, though, since it relieves pain and lowers fevers, but it is not an anti-inflammatory medicine.

Combined with aspirin, you get the anti-clotting, pain relief, lower fever, and anti-inflammatory properties.

[neverdem]

I recently read an expert source that suggested that the benefits of aspirin were so mild that these benefits were countered by the increased risks of bleeding and such that are known to be associated with aspirin use.

It depends on the questions.

Aspirin for primary prevention of myocardial infarction: what is the evidence?

CONCLUSIONS: This analysis does not support a general recommendation for the use of aspirin for primary prevention of MI and also suggests that effective management of risk factors in accordance with current guidelines may attenuate any potential benefit from aspirin with respect to MI. However, there may be a modest benefit in postmenopausal women with respect to stroke.

[Evidence-based management of ST-segment elevation myocardial infarction (STEMI). Latest guidelines of the European Society of Cardiology (ESC) 2010].

Secondary prevention? You betcha! Unless you have an aspirin allergy or have knowledge that you're in roughly twenty percent of the population that are aspirin resistant. The Germans are going with dual antiplatelet therapy for a year.

(ST-segment elevation myocardial infarction refers to electrocardiogram findings in a typical "heart atack.")(ASA = aspirin)

[John S Mosby]

NSAID= Non- Steroidal Anti- Inflammatory Agent.

These are drugs like-
Aspirin (acetylsalicylic Acid) the standard for anti-inflammatories (aspirin’s main problem is action in the stomach to slow/stop prostaglandins which protect the stomach lining from the PH2 acid produced there- acid eats the exposed lining— bleeding in the stomach. ANSWER: take coated aspirin brand/non brand. The coating does not dissolve in pH2 in the stomach but later in the duodenum at pH 5 or so and releases aspirin the bloodstream

Celebrex (and other COX-2 inhibitors),

Ibuprofen any brand

Naproxen sodium, any brand

Tylenol (paracetamol, or acetominophen: has liver toxicity in high doses, and is thought to be the most common cause of liver failure in the US— too much acetominophen). Not good for folks who are heavy alcohol drinkers— lowers the toxicity levels, liver can’t keep up making enough glutathione to counteract a major metabolite of tylenol. Space the doses out— SEAL candy, when no drinkee.

Problem with all NSAIDs is in the kidney and clearing, affecting renal function. Not a good thing if someone has heart disease or beginning heart failure (and needs all the function kidney can manage). But the heck of it is, older people need the NSAIDs for muscular and joint pains that are naturally there.
Deo Vindice.

[neverdem]

Thanks for the link. Wikipedia is a good source if the topic isn’t political.

[steve86]

So take curcumin instead. Widely available or just eat a lot of tumeric.

Curcumin does have both anti-inflammatory and sometimes analgesic properties, but you have to be real careful with heart attack patients casually telling them to stop a mainstream drug and try something else.