Use of nonsteroidal antiinflammatory drugs: an update for clinicians. A scientific statement from the American Heart Association

Use of nonsteroidal antiinflammatory drugs: an update for clinicians. A scientific statement from the American Heart Association

1st March 2007
American Heart Association
Summary, Abstract

Source: National Guidelines Clearinghouse

GUIDELINE OBJECTIVE(S)

To provide updated recommendation for the use of nonsteroidal antiinflammatory drugs (NSAIDs) in patients with known cardiovascular disease or risk factors for ischemic heart disease

TARGET POPULATION

Patients with musculoskeletal symptoms with known cardiovascular disease or risk factors for ischemic heart disease taking nonsteroidal antiinflammatory drugs (NSAIDs)

INTERVENTIONS AND PRACTICES CONSIDERED

Stepped care approach to pharmacologic therapy including:

  1. Acetaminophen, aspirin, tramadol, narcotic analgesics (short term)
  2. Nonacetylated salicylates
  3. Non cyclooxygenase (COX)-2 selective nonsteroidal antiinflammatory drugs (NSAIDs)
  4. NSAIDs with some COX-2 activity
  5. COX-2 selective NSAIDS
  6. Addition of aspirin and proton pump inhibitors (PPIs) for patients at increased risk of thrombotic events receiving NSAIDs
  7. Regular monitoring for side effects of NSAIDs
  8. Reduction of the dose or discontinuation of the offending NSAID
MAJOR OUTCOMES CONSIDERED
  • Adverse effects of nonsteroidal antiinflammatory drugs (NSAIDs)
  • Safety and efficacy of NSAIDs