Klin Farmakol Farm. 2011;25(3):131-137

Cardiovascular risk of non-steroidal anti-inflammatory drugs - clinical impact and possible mechanisms

Zoltán Varga, Viera Kristová, Milan Kriška

Ústav farmakológie a klinickej farmakológie, Lekárska fakulta, Univerzita Komenského v Bratislave

Non-steroidal anti-inflammatory drugs are medicines with analgesic, antipyretic and anti-inflammatory effects. Their effects are achieved

by reducing the synthesis of prostanoids. Inhibition of prostanoid production is responsible for a substantial risk of adverse effects.

The risk of adverse effects affecting the gastrointestinal tract and the kidneys has long been recognised. The possibility of increased

blood pressure and development/worsening of heart failure during treatment is also known for decades. Increased incidence of acute

myocardial infarction in clinical trials with rofecoxib drew attention to possible cardiotoxicity of selective cyclooxygenase-2 inhibitors,

doubts have arisen about cardiovascular safety of non-selective drugs from this group. The question about cardiovascular safety of

non-steroidal anti-inflammatory drugs has been addressed in recent years in large number of retrospective and prospective clinical

studies and meta-analyses. Results indicate that cardiotoxicity might be class effect of non-steroidal anti-inflammatory drugs. Substantial

variability is present among drugs in burden of risk. The aim of our work is to summarize available data about risk of cardiovascular

adverse effects of non-steroidal anti-inflammatory drugs, their clinical impact and possible mechanisms responsible for the risk of the

mentioned side effects.

heart failure.

Keywords: non-steroidal anti-inflammatory drugs, cardiovascular risk, adverse effect, cardiovascular event, arterial hypertension,

Published: December 1, 2011  Show citation