MARIOS DIMOPOULOS

MARIOS DIMOPOULOS
Marios Dimopoulos Clinical Nutritionist, Author, Fellow of the American Council of the Applied Clinical Nutrition

Πέμπτη, 2 Οκτωβρίου 2014

Common Painkillers Tied to Blood Clot Risk, Study Suggests

By Robert Preidt, HealthDay Reporter
WEDNESDAY, Sept. 24, 2014 (HealthDay News) -- People who use painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs) -- which include aspirin, naproxen (Aleve) and ibuprofen (Advil, Motrin) -- may be at increased risk for potentially deadly blood clots, a new study suggests.
But the study only showed an association between use of the painkillers and higher clotting risk; it did not prove cause-and-effect.
The researchers analyzed the results of six studies involving more than 21,000 cases of a type of blood clot called a venous thromboembolism (VTE).
These clots include deep vein thrombosis (a clot in the leg) and pulmonary embolism (a clot in the lungs).
Reporting online Sept. 24 in Rheumatology, the analysis found that people who used NSAIDs had an 80 percent higher risk for venous clots.
"Our results show a statistically significant increased VTE risk among NSAID users. Why NSAIDs may increase the risk of VTE is unclear," study lead author Patompong Ungprasert, of Bassett Medical Center in Cooperstown, N.Y., said in a journal news release.
"Physicians should be aware of this association and NSAIDs should be prescribed with caution, especially in patients already at a higher risk of VTE," the researcher added.
Ungprasert noted that all types of NSAIDs were evaluated as one group, but not all types of NSAIDs may boost the risk of VTE.
Two experts said the findings are in keeping with prior research.
"It is not entirely surprising that NSAIDs are again implicated in causing clot-related illness," said Dr. Steven Carsons, chief of the division of rheumatology, allergy and immunology at Winthrop-University Hospital in Mineola, N.Y.
He pointed to the case of Vioxx, a powerful NSAID painkiller that was withdrawn from the market in 2004, after studies found a higher risk of heart attack and stroke in users.
The new study "makes a compelling case for further study and clinical surveillance for venous clotting events in those patients taking NSAIDs," Carsons said. However, he stressed that the study could not pinpoint which types of NSAIDs might pose the greatest risk, or which type of patients might be most vulnerable.
According to Carsons, "aspirin, the 'original' NSAID, has sufficient anti-clotting properties to be effective for prevention of VTEs, and most studies show that naproxen (Aleve) -- a common prescribed and over-the-counter NSAID -- carries no additional clotting risk."
Dr. Suzanne Steinbaum is a preventive cardiologist at Lenox Hill Hospital in New York City. She said that "without discerning which NSAIDS are more safe than others, this study shows the potential increase in VTE. It is important that both physicians and patients understand this risk, especially for those people who are already at risk for VTE."
More information
The American Academy of Family Physicians has more about deep vein thrombosis.


People who use painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs) -- which include aspirin, naproxen (Aleve) and ibuprofen (Advil, Motrin) -- may be at increased risk for potentially deadly blood clots, a new study suggests.


But the study only showed an association between use of the painkillers and higher clotting risk; it did not prove cause-and-effect.

The researchers analyzed the results of six studies involving more than 21,000 cases of a type of blood clot called a venous thromboembolism (VTE).

These clots include deep vein thrombosis (a clot in the leg) and pulmonary embolism (a clot in the lungs).

Reporting online Sept. 24 in Rheumatology, the analysis found that people who used NSAIDs had an 80 percent higher risk for venous clots.

"Our results show a statistically significant increased VTE risk among NSAID users. Why NSAIDs may increase the risk of VTE is unclear," study lead author Patompong Ungprasert, of Bassett Medical Center in Cooperstown, N.Y., said in a journal news release.

"Physicians should be aware of this association and NSAIDs should be prescribed with caution, especially in patients already at a higher risk of VTE," the researcher added.

Ungprasert noted that all types of NSAIDs were evaluated as one group, but not all types of NSAIDs may boost the risk of VTE.

Two experts said the findings are in keeping with prior research.

"It is not entirely surprising that NSAIDs are again implicated in causing clot-related illness," said Dr. Steven Carsons, chief of the division of rheumatology, allergy and immunology at Winthrop-University Hospital in Mineola, N.Y.

He pointed to the case of Vioxx, a powerful NSAID painkiller that was withdrawn from the market in 2004, after studies found a higher risk of heart attack and stroke in users.

The new study "makes a compelling case for further study and clinical surveillance for venous clotting events in those patients taking NSAIDs," Carsons said. However, he stressed that the study could not pinpoint which types of NSAIDs might pose the greatest risk, or which type of patients might be most vulnerable.

According to Carsons, "aspirin, the 'original' NSAID, has sufficient anti-clotting properties to be effective for prevention of VTEs, and most studies show that naproxen (Aleve) -- a common prescribed and over-the-counter NSAID -- carries no additional clotting risk."

Dr. Suzanne Steinbaum is a preventive cardiologist at Lenox Hill Hospital in New York City. She said that "without discerning which NSAIDS are more safe than others, this study shows the potential increase in VTE. It is important that both physicians and patients understand this risk, especially for those people who are already at risk for VTE."

http://www.newsmaxhealth.com/Health-News/blood-clot-ibuprofen-aspirin/2014/09/25/id/596802/?promo_code=12D25-1

Increased risk of venous thromboembolism among NSAIDs users, study shows

Date:
September 24, 2014
Source:
Oxford University Press
Summary:
There is a statistically significant increased risk of venous thromboembolism -- a condition which includes deep vein thrombosis and pulmonary embolism -- among users of non-steroidal anti-inflammatory drugs, a study concludes. NSAIDs are one of the most commonly used medications around the world, and they are already well-known for their potential adverse effects.


A new study published online today in the journal Rheumatology demonstrates that there is a statistically significant increased risk of venous thromboembolism (VTE) -- a condition which includes deep vein thrombosis and pulmonary embolism -- among users of non-steroidal anti-inflammatory drugs (NSAIDs). This finding has important public health implications given the prevalence of NSAID use in the general population.
NSAIDs are one of the most commonly used medications around the world, and they are already well-known for their potential adverse effects. However, the epidemiological data on the risk of VTE among NSAIDs users is limited. In this new study, a team of researchers led by Patompong Ungprasert of Bassett Medical Centre, New York, conducted a systematic review and meta-analysis of observational studies that compared the risk of VTE in NSAID users versus non-users.
Six studies (one cohort study and five case-control studies) with 21,401 VTE events were included in the analysis, which demonstrated a statistically significant increased VTE risk among subjects who used NSAIDs, with an overall 1.80-fold increased risk compared with subjects who did not use NSAIDs.
The study's lead author, Patompong Ungprasert, comments: "This is the first systematic review and meta-analysis of published observational studies assessing the risk of VTE among NSAIDs users. There are some limitations, however, such as the fact that all NSAIDs are evaluated as one group in this study but not all individual NSAIDs may increase the risk of VTE.
"Our results show a statistically significant increased VTE risk among NSAIDs users. Why NSAIDs may increase the risk of VTE is unclear. It is possibly related to COX-2 inhibition leading to thromboxane-prostacyclin imbalance. Physicians should be aware of this association and NSAIDs should be prescribed with caution, especially in patients already at a higher risk of VTE."

Story Source:
The above story is based on materials provided by Oxford University Press. Note: Materials may be edited for content and length.

Journal Reference:
  1. P. Ungprasert, N. Srivali, K. Wijarnpreecha, P. Charoenpong, E. L. Knight. Non-steroidal anti-inflammatory drugs and risk of venous thromboembolism: a systematic review and meta-analysis. Rheumatology, 2014; DOI: 10.1093/rheumatology/keu408

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