Related Experiment Video

Updated: Jul 14, 2026

Protection of H9c2 Myocardial Cells from Oxidative Stress by Crocetin via PINK1/Parkin Pathway-Mediated Mitophagy
07:40

Protection of H9c2 Myocardial Cells from Oxidative Stress by Crocetin via PINK1/Parkin Pathway-Mediated Mitophagy

Published on: May 26, 2023

Diclofenac and acute myocardial infarction in patients with no major risk factors

Susan S Jick1, James A Kaye, Hershel Jick

  • 1Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, MA 02421, USA. sjick@bu.edu

British Journal of Clinical Pharmacology
|May 19, 2007
PubMed

Insights

Extensive diclofenac use significantly raises the risk of acute myocardial infarction (AMI). Ibuprofen and naproxen showed little to no increased AMI risk in long-term users.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacovigilance
  • Epidemiology

Background:

  • Recent findings suggest diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), may increase acute myocardial infarction (AMI) risk.
  • This risk appears similar to that associated with rofecoxib and celecoxib.

Purpose of the Study:

  • To investigate the association between long-term use of diclofenac and the risk of AMI.
  • To compare the AMI risk associated with diclofenac to that of ibuprofen and naproxen.

Main Methods:

  • Three nested case-control studies were conducted using the General Practice Research Database.
  • NSAID use (diclofenac, ibuprofen, naproxen) initiated after January 1, 1993, was analyzed for AMI cases between 1993 and 2000.
  • Relative risk (RR) for AMI was calculated based on the number of prescriptions, adjusted for potential confounding factors.

Main Results:

  • Diclofenac use, particularly with 10 or more prescriptions, showed a substantial increase in AMI risk (RR 1.9-2.0).
  • Ibuprofen and naproxen use, even with 20 or more prescriptions, did not demonstrate a significant elevation in AMI risk.

Conclusions:

  • Extensive use of diclofenac is associated with a significantly increased risk of acute myocardial infarction.
  • Ibuprofen and naproxen do not appear to carry a similar elevated risk of AMI with long-term use.
Abstract

More Related Videos

Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease04:41

Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease

Published on: July 3, 2018

Related Concept Videos

Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...