NSAIDS Leaky Gut and Heart Attacks

[image error] NSAIDS Leaky Gut and Heart Attacks

By Jeffrey Dach MD

Jim takes Naproxen, an NSAID pain pill, on a regular basis for relief of arthritis pain.  In addition, Jim’s Calcium Score is very high, and in fact, Jim had a coronary stent placed about 5 years ago during cardiac catheterization for chest pain. Jim wants to know why he should stop the NSAID arthritis drugs, and switch to a safer and more effective botanical alternative such as Zyflamend by New Chapter.

[image error]NSAID drugs have been associated with increased heart attacks for many years now.(1-9)

The 2000 Vioxx Scandal  was due to increased heart attack rate discovered years later after a introduction of a new NSAID drug called Vioxxx (Rofecoxib).  In November 2007, Merck announced a $4.85 billion settlement with 47,000 plaintiffs claiming Vioxx caused their heart attack, the largest drug settlement in drug history.(10)

All NSAIDS Cause Heart Attacks

However, this problem is not restricted to Vioxx.  In fact, all NSAID drugs  are associated with increased heart attack risk according to a recent publication in the British Medical Journal.(1)

What is the mechanism by which NSAIDS cause heart attacks ?  None of the medical publications take the next step of explaining the mechanism by which NSAIDS cause heart attacks.(2-9)  In my opinion, the obvious explanation is “LEAKY GUT” with low level endotoxemia.

NSAIDS Cause Leaky Gut

[image error]My previous article on NSAIDS and Leaky Gut discusses the overwhelming evidence that NSAIDS cause leaky gut.  Animal studies show NSAID induced damage to the small bowel intestinal brush border, with increased intestinal permeability and “Leaky Gut” in virtually all animals treated with NSAIDS. Left Image: Brush Border of Small Bowel

NSAIDS Cause Leaky Gut Which Causes Heart Disease

[image error]My previous article on the Low Level Endotoxemia – LPS theory of heart disease explains the mechanism by which  Leaky Gut causes low level endotoxemia, a known risk factor for coronary artery disease and increased risk for heart attacks.  Low level endotoxemia is the fancy medical name for leakage of gut bacteria into the blood stream.  This has been directly linked to causing atherosclerotic plaque, a form of infected biofilm as discussed in my previous article on this topic.

Conclusion: The obvious mechanism by which NSAID drugs cause coronary artery disease and increased heart attack risk is “Leaky Gut”.  This allows leakage of LPS and gram negative bacteria into the blood stream, a form of “low level endotoxemia”, directly linked to atherosclerotic disease.   Avoiding NSAID drugs is essential for healing the gut and preventing coronary artery disease.

Jeffrey Dach MD

Articles with Related Interest

Atherosclerotic Plaque as Infected Biofilm

NSAIDS, Small Bowel and Leaky Gut

Low Level Endotoxemia LPS Theory of Coronary Artery Disease

Low Level Endotoxemia, Depression, Endocrinopathy and Coronary Artery Disease by Jeffrey Dach MD

Links and References:

1) NSAIDS, Small Bowel and Leaky Gut by Jeffrey Dach MD

2) Bally, Michèle, et al. “Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data.” bmj 357 (2017): j1909. Objective To characterise the determinants, time course, and risks of acute myocardial infarction associated with use of oral non-steroidal anti-inflammatory drugs (NSAIDs).

Results A cohort of 446 763 individuals including 61 460 with acute myocardial infarction was acquired. Taking any dose of NSAIDs for one week, one month, or more than a month was associated with an increased risk of myocardial infarction. With use for one to seven days the probability of increased myocardial infarction risk (posterior probability of odds ratio >1.0) was 92% for celecoxib, 97% for ibuprofen, and 99% for diclofenac, naproxen, and rofecoxib. The corresponding odds ratios (95% credible intervals) were 1.24 (0.91 to 1.82) for celecoxib, 1.48 (1.00 to 2.26) for ibuprofen, 1.50 (1.06 to 2.04) for diclofenac, 1.53 (1.07 to 2.33) for naproxen, and 1.58 (1.07 to 2.17) for rofecoxib. Greater risk of myocardial infarction was documented for higher dose of NSAIDs. With use for longer than one month, risks did not appear to exceed those associated with shorter durations.

Conclusions All NSAIDs, including naproxen, were found to be associated with an increased risk of acute myocardial infarction. Risk of myocardial infarction with celecoxib was comparable to that of traditional NSAIDS and was lower than for rofecoxib. Risk was greatest during the first month of NSAID use and with higher doses.

Data from nearly half a million patients – a total cohort of 446,763 people – showed that any dose of NSAIDs is associated with an increased risk of heart attack, even within the first week of use. Comparing people who took painkillers to those who didn’t, the team found an increase of heart attack risk of about 20-50 percent, with a similar result for all the different NSAIDs they looked at.

3) Johnsen, Søren P., et al. “Risk of hospitalization for myocardial infarction among users of rofecoxib, celecoxib, and other NSAIDs: a population-based case-control study.” Archives of internal medicine 165.9 (2005): 978-984.

Conclusions :Current and new users of all classes of non- aspirin NSAIDs had elevated relative risk estimates for

MI. Although the increased risk estimates may partly re-flect unmeasured bias, they indicate the need for fur-ther examination of the cardiovascular safety of all nonaspirin NSAIDs.

4) Olsen, Anne-Marie Schjerning, et al. “Long-term cardiovascular risk of NSAID use according to time passed after first-time myocardial infarction: a nationwide cohort study.” Circulation (2012): CIRCULATIONAHA-112.

5) Leaky Gut Syndrome Isn’t Only Scary, But Extremely Dangerous to Your Health – This is More Than a Poop Issue!

by Jordan Reasoner

6) Kohli, Payal, et al. “NSAID use and association with cardiovascular outcomes in outpatients with stable atherothrombotic disease.” The American journal of medicine 127.1 (2014): 53-60.

Among patients with stable atherothrombosis, NSAID use is associated with a higher risk of myocardial infarction, stroke, and hospitalizations for both ischemia and heart failure.

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7) The Guardian  –  Common painkillers may raise risk of heart attack by 100% – study.  Risk of myocardial infarction is greatest in first month of taking NSAIDs such as ibuprofen if dose is high, say researchers

For the paper, published in the BMJ on Tuesday, the researchers analysed results on 446,763 people on healthcare databases in countries including Canada, Finland and the UK, of whom 61,460 had a heart attack.

They said the potential increase in risk was 75% for ibuprofen and naproxen and more than 100% for rofecoxib but that uncertainty about the extent of the increased risk was greatest for ibuprofen and naproxen.

8) The Guardian – Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

Over-the-counter drug linked to 31% increased cardiac arrest risk, with the figure rising to 50% for diclofenac, says research

9) FDA strengthens warning that NSAIDs increase heart attack and stroke risk July 13, 2015 Gregory Curfman, MD, Editor in Chief, Harvard Health Publications

10) 1999 Vioxx Scandal

link to this article: http://wp.me/p3gFbV-53X

Jeffrey Dach MD

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