Nonsteroidal Anti-inflammatory Drug Use and Acute Myocardial Infarction

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Abstract
RECENT PUBLICATION of the study by Bombardier et al1 has rekindled interest in the relationship between nonsteroidal anti-inflammatory drug (NSAID) use and acute myocardial infarction (AMI). Despite the anti-inflammatory and antiplatelet effects of NSAIDs, there has never been a randomized controlled trial that examined whether these drugs confer the protective effects of aspirin against AMI. In fact, in the study by Bombardier et al, patients with rheumatoid arthritis randomized to receive rofecoxib had a significantly higher rate of AMI than patients randomized to receive naproxen.1 Controversy has emerged as to whether this result was the consequence of a protective effect of naproxen, an increase in the risk of AMI caused by rofecoxib, or both.

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