Previous studies have suggested that acute respiratory infections (ARI) and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) can trigger acute myocardial infarctions (AMI). As physicians in some countries prescribe NSAIDs for symptom relief during ARI the authors were interested in evaluating the evidence for this link. They identified 9793 patients with an incident hospitalisation for AMI between 2007 and 2011. Using case-crossover design, they then compared the exposure status of cases (1-7 days before AMI) and the matched control period (366-372 days before AMR). They found that NSAID use during ARI was associated with a 3.4-fold increased risk of AMI (adjusted odds ratio [aOR] 3.41, 95%CI 2.80-4.16), ARI without NSAIDs use was associated with a 2.7-fold increased risk (aOR 2.65, 95%CI 2.29-3.06) and NSAID-use only was associated with a 1.5-fold increased risk (aOR 1.47, 95%CI 1.33-1.62). Importantly, parenteral NSAIDs were associated with a much higher risk of AMI in ARI patients (aOR 7.22, 95%CI 4.07-12.81). Therefore nonsteroidal anti-inflammatory drug-use during ARI episodes, especially via the parenteral route, is associated with a further increased risk of AMI.
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