EVALUATING THE CARDIOVASCULAR RISKS ASSOCIATED WITH NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) NEW APPROACHES IN PAIN MANAGEMENT
Main Article Content
Keywords
NSAIDs, cardiovascular risks, pain treatment, alternatives
Abstract
Background: Analgesic anti-inflammatory drugs, especially NSAIDs, are commonly used in treating pain while they bear a range of cardiovascular hazards such as elevated risk of myocardial infarction and stroke. Establishing the magnitude of these risks in these subgroups is important in maximizing pain relief approaches while minimizing adverse cardiovascular repercussions.
Objectives: In order to assess the cardiovascular risks of NSAIDs in patients as well as consider other better pain relief strategies that address such risks.
Study design: A prospective cohort study
Duration and place of study. Department of pharmacology Watim Medical and Dental College Rawalpindi from jan 2021 to jan 2022
Methods: This prospective cohort study recruiting 120 patients, aged between 45 and 75 years and on NSAID therapy for chronic pain. Patients were divided into two groups: participants with a history of cardiovascular disease (n= 60) and those participants with no history of cardiovascular disease (n= 60). The cardiovascular events were recorded after three months and then for the next three months. For cardiovascular outcome measures SD was estimated, and p-value was used to evaluate the statistical difference.
Results: Patients with prior cardiovascular disease had increased cardiovascular event risk by 30% (p<0.05). The mean incidence of myocardial infraction was 12 % ( ± 2.5) in the cardiovascular group and 5 % (± 1.8) in the non cardiovascular group. Consumption of topical NSAIDs reduced cardiovascular occurrences of the disease to significance level p < 0.01. Milliseconds to hours to days and overall adverse events were fewer with acetaminophen as an alternative.
Conclusions: Patients on NSAID therapy have a three times higher cardiovascular risk than people not on NSAID therapy and patients with preexisting cardiovascular disease have a 5 fold higher risk of suffering from a cardiovascular event. Other OTEs like non oral topical NSAID and Acetaminophen proves less risky, especially among the vulnerable people. The guidelines for the future should focus on the strategies concerning the treatment of pain for each patient.
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Adnan Bashir
Associate professor pharmacology Watim medical and dental college Rawalpindi
Sohail Iqbal
Associate Professor Institute: Muhammad College of Medicine Peshawar
Rao Salman Aziz
Associate Professor Pharmacology Rashid Latif medical & dental college Lahore
Usman Saeed
Associate Professor pharmacology Fatima memorial college of medicine and dentistry