Comparative Cardiovascular Efficacy & Safety of NSAIDs: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abstract

NSAIDs, or nonsteroidal anti-inflammatory medications, are popular and efficient analgesis and frequent mainstay treatements for inflammatory disorders. However, their cardiovascular safety is questionable. The aims of the current study were: (1) to evaluate the comparative cardiovascular efficacy of NSAIDs; (2) to investigate the cardiovascular safety and risks associated with NSAID use; (3) to highlight the importance of alternative therapies for patients who display contraindications to NSAID. A number of digital databases were explored to retrieve relevant studies. These consist of ClinicalTrials.gov, PubMed, Google Scholar, ScienceDirect, etc. The final sample consisted of 17 primary studies.A total of 12/17 (71%) studies advocated the efficacy and safety of NSAIDs. The remaining 2/17 (11%) showed that there was no discernible difference between the NSAID and non-NSAID groups in terms of mortality, cardio-respiratory morbidity, and cardiovascular risk. A forest plot was created using data from eight distinct studies. The results for the incidence of cardiovascular events were found to be statistically significant. The heterogeneity was calculated to be Tau2= 0.15; Chi2=117.67; df=6; I2=95%. The overall effect size was found to be Z=0.08 (p<0.94); the Hazard Ratio was found to be 0.84, CI=95% (CI, 0.72 = 0.98). Certain agents have a higher risk of causing unfavorable cardiovascular events, although other agents might have a safer profile. Clinicians must have this comprehensive knowledge to balance the therapeutic benefits of NSAIDs with any potential cardiovascular hazards when making judgments.