Non-steroidal anti-inflammatory drugs linked with heart failure in patients with diabetes (Over 65 or poorly controlled diabetes)

Medical Xpress / European Society of Cardiology / ESC Congress 2022 ^ | August 23, 2022 | Dr. Anders Holt et al

[ConservativeMind]

Short-term use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with a first-time hospitalization for heart failure in patients with type 2 diabetes, according to research.

This study investigated the association between short-term NSAID use and the risk of first-time heart failure hospitalization in a nationwide cohort of patients with type 2 diabetes. Information was collected on prescriptions for oral NSAIDs (celecoxib, diclofenac, ibuprofen, and naproxen) claimed prior to first-time heart failure hospitalization. Using a case-crossover design in which each patient acted as his or her own control, associations between short-term NSAID use and the risk of first-time heart failure hospitalization were assessed.

NSAID use was associated with an elevated risk of first-time heart failure hospitalization, with an odds ratio (OR) of 1.43 (95% confidence interval [CI] 1.27–1.63). When individual NSAIDs were analyzed separately, the risk of heart failure hospitalization was increased following the use of diclofenac or ibuprofen, with corresponding ORs of 1.48 (95% CI 1.10–2.00) and 1.46 (95% CI 1.26–1.69), respectively. Celecoxib and naproxen were not associated with an increased risk, potentially due to the small proportion of prescriptions.

The researchers analyzed the risk of heart failure with NSAID use in subgroups. No association was found in patients with normal glycated hemoglobin (HbA1c) levels (below 48 mmol/mol), which indicates well-controlled diabetes. Strong associations were found in patients above 65 years of age, while no association was found in those below 65 years of age. The strongest association was found in very infrequent or new users of NSAIDs.

He concluded: "The results suggest that a potential increased risk of heart failure should be taken into account when considering the use of these medications. On the contrary, the data indicate that it may be safe to prescribe short-term NSAIDs for patients below 65 years of age and those with well-controlled diabetes."

[ConservativeMind]

At the very least, even if the drugs aren’t responsible for the added risk, get your diabetes under control and also try to reduce, in a healthy way, the root causes of your pain.

[ConservativeMind]

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[BipolarBob]

And they can cause your cataracts to worsen significantly. Nsaids should be used cautiously and as infrequently as possible.

[catnipman]

and there’s the well documented role of NSAIDs in kidney damage caused by the triple whammy ...

https://www.google.com/search?q=nsaids+triple+whammy+kidney

https://www.sciencedirect.com/science/article/abs/pii/S0025556422000232

[Celtic Conservative]

Due to my back I use NSAIDs, but my sugars are rock solid. (5.4 A1C)

CC

[nwrep]

Is aspirin considered as NSAID?

[TChad]

NSAID bump for later

[TChad]

Is aspirin considered as NSAID?

Yes, but not low dose.

[Myrddin]

My bedtime dose of ibuprofen is 800 mg. Every day. It keeps my rheumatoid arthritis in check. When I last went for a colonoscopy in 2013, I was required to discontinue ibuprofen for 2 weeks prior to the procedure. It was almost impossible to sleep with the unsuppressed pain. I did the procedure. They clipped a few polyps. A week later, I needed to mow the lawn. The mower was unwilling to start after a vigorous attempt to start the engine. The bad news follows: a toilet bowl that looked like a tequila sunrise. Off to the hospital. I ripped a scab off one of the polyp "snips" that was right over a blood vessel. It took 6 hours of drinking "Golytely" to clear my gut sufficiently for an emergency colonoscopy to stop the hemorrhaging. My BP was dropping all night. The ER did a type/cross match in case I needed a transfusion. 5:30 AM and off to the OR to stop the bleeder. Another 3 weeks with no ibuprofen (reconnecting to the point of the post). The RA left lots of damage behind without the ibuprofen suppression. I'm not doing that again. An elective procedure. That wasn't all. The "prep" for the original colonoscopy included Amitiza. Minutes after I took that pill, my lungs began filling with fluid. Oh joy! It's only supposed to dump saline fluid in the bowel unless you are one of the unfortunate 0.1% of people who have saline dumped in the lungs. I had to sit up for 6 hours coughing the saline from my lungs to avoid drowning in my own fluids. Never again.

Post script: the DNA submission I did to Ancestry gave me entree to a database that bashed my genetic profile against diseases and medications. My phenotype tolerates ibuprofen with no ill effect. The daily 800 mg dose isn't going to harm me and does keep the RA at bay. My BMI is 20.4. Body fat percentage 15. Weight 154. Satisfactory at almost age 66.

[Repeal The 17th]

“...Is aspirin considered as NSAID?...”
-
“...Yes, but not low dose...”
-
NSAID is not determined by dosage.
Yes!
Aspirin is indeed a Non Steroidial Anti Inflamfatory Drug!

[Repeal The 17th]

See: https://freerepublic.com/focus/chat/4087837/posts?page=10#10
-
“...Is aspirin considered as NSAID?...”
-
“...Yes, but not low dose...”
-
NSAID is not determined by dosage.
Yes!
Aspirin is indeed a Non Steroidial Anti Inflamfatory Drug!

[Graybeard58]

Sounds like you been through hell and back. I’m genuinely sorry to hear that.

[jcon40]

Years ago I lost 2” in height from a car wreck. Was paralyzed waist down first few hours. 2 crushed vertebrae and 2 fractured v. Years of pain.

Used to take NSAIDs but for last few years use CBD orally (moderately) and topically (lots)

They wanted to operate at the time of the accident. Still no surgeries. I’m 72 and work physically every day,

Also take fish oils and circumin.

Know several others doing the same. Not perfect but gives relief.

[telescope115]

I had a similar experience after a colonoscopy. The doctor removed multiple polyps, and about a week after the procedure I was in the hospital with a possible heart attack- the next day I was on the treadmill for a stress test, which blew the scab right off of one of those wounds, causing a massive bleed, making me pass out right outside the cath lab.
Before they could address my heart issue, they had to stop the bleeding.
That night in the hospital, I was drinking the prep, while undergoing a blood transfusion at the same time. They put 4bags of blood thru me that night.
The next day the GI doc patched me up inside, and the day after THAT I was injected with an isotope, and they found a partially blocked coronary artery.
No heart attack, Thank God.
To the original subject; the doctor had me on Vioxx for arthritis in my back years ago, and it made my heart pound. They later took it off the market, it was a heart attack and stroke risk.
I can take acetaminophen, that’s about it. I do one baby aspirin every day but regular strength aspirin and ibuprofen-no.

[Celtic Conservative]

I have a degenerative condition that is a birth defect. It’s inoperable unfortunately. I’m as active as the condition will let me be.

CC

[Myrddin]

Vioxx was a mistake. It only suppressed COX-2 leaving the 5-LOX pathway with extra substrate. See 5-Lipoxygenase Metabolic Contributions to NSAID-Induced Organ Toxicity. You had more "snips" and went all the way to hanging the bags of blood. I was within 30 minutes of needing blood when my gut cleared enough to fix the problem.

I avoid acetaminophen. It is toxic. It depletes both glutathione and lithium. Long term use destroys the ability to recognize right vs wrong. An overdose kills the liver.

I hope you're doing better after catching the heart issue before it progressed to a heart attack.

[TChad]

I can't find my source for the notion that low-dose aspirin is not considered an NSAID, and in any case it was wrong. Low dose aspirin does have anti-inflammatory effects.

I retract post #8.

[telescope115]

Thanks, my heart is fine, a clot buster drug did the trick.
When I was being tested for transplant surgery, they had me in the MRI for 45 minutes imaging my heart. The tech said he took over 2000 images of my heart.
Everything was good.
I only take acetaminophen if I absolutely must, I have ulcerative colitis, and any other anti-inflammatory can cause intestinal bleeding.
I received a new liver last year, but not because of painkillers or alcohol. My overactive immune system was slowly destroying it, and it had already caused irreversible damage to my liver.
I’m doing great! I’m taking long walks, getting back into my hobbies, and life is good!

Talk about gut clearing, when I blacked out, I left one hell of a bloody mess all over the wheel chair that I was sitting in. I can laugh about it now, but man, at the time it was pretty scary.

Best of health to you!😀

[telescope115]

I went back and read your original post, and I really do wish you the best.
Rheumatoid Arthritis is nothing to take lightly, and you really have been thru a lot. Life ain’t fair.

[ckilmer]

NSID’s are killers.

If you do them at all—follow the rules on the box. take them only briefly.

take them for long periods for chronic pain and your cardiovascular system will go hell.