Taking pain killers during flu may up heart attack risk: study

Taking pain relievers during a cold or flu-like illness may increase the risk of heart attack, a new study of 10,000 patients has warned.
Researchers at National Taiwan University Hospital in Taiwan suggest physicians and patients should use caution when prescribing or taking the medications, known as nonsteroidal anti-inflammatory drugs (NSAIDs), to ease symptoms of acute respiratory infections.
In an observational study, researchers analysed claims from Taiwan's National Health Insurance Programme over a seven-year period (2005-2011), including data from nearly 10,000 patients who were hospitalised for a heart attack.
The goal was to study whether two potential cardiac risk factors - an acute respiratory infection, such as a cold or influenza, and NSAID use - have a combined, joint effect on heart attack risk.

Researchers compared each patients' own risk for heart attack over time, across episodes of respiratory illness and NSAID use. They found a stronger association with a heart attack when both risk factors were present.
Using the pain relievers during an acute respiratory infection was associated with a 3.4-fold increased risk for a heart attack, with 7.2 times greater risk when patients received the pain-relieving medication intravenously in the hospital, compared to times when patients had neither of the risk factors.

The heart attack risk when patients with an acute respiratory illness were not taking an NSAID was 2.7 times greater, while the risk was 1.5 times greater when individuals took the drugs and did not have an infection.

Previous research has implicated respiratory infections and some NSAIDs as potential triggers for heart problems, but earlier studies have examined these risk factors only separately.
"Physicians should be aware that the use of NSAIDs during an acute respiratory infection might further increase the risk of a heart attack," said study author Cheng-Chung Fang, from National Taiwan University Hospital.
Patients seeking relief from cold and flu symptoms should consult with their doctor or a pharmacist before using NSAIDs, said Fang.
Another commonly used pain reliever, acetaminophen, which eases pain in a different way than NSAIDs do, may be a safer alternative, in terms of cardiac risk, for relief from cold and flu symptoms, although the drug was not evaluated in the study.

While the study's findings suggest an association between NSAID use, acute respiratory infections, and increased cardiac risk, they do not prove a cause-and-effect relationship.
Additional research is needed to clarify the apparent combined effect on risk and how the effect might be managed.
The study was published in the Journal of Infectious Diseases.