Hindari Penggunaan NSAID pada Orang dengan Faktor Risiko Kejadian Kardiovaskular

Oleh :

Debtia Rahmah

Studi terkini menunjukkan semua golongan non-steroid anti-inflammatory drug (NSAID) atau obat antiinflamasi nonsteroid (OAINS), kecuali aspirin, meningkatkan risiko terjadinya infark miokard. Penggunaan NSAID harus dihindari pada orang yang memiliki faktor risiko kejadian kardiovaskular, dan juga pada pasien dengan riwayat infark miokard sebelumnya.

Non steroid Anti Inflammatory Drug (NSAID) termasuk obat yang sering diresepkan untuk penanganan myalgia, arthritis rheumatoid, gout, maupun penyakit dengan gejala peradangan lainnya. Sayangnya, efek samping penggunaan NSAID terhadap sistem kardiovaskular sering kali tidak menjadi pertimbangan dokter ketika hendak meresepkan NSAID pada pasien. Padahal NSAID seharusnya dihindari pada orang dengan faktor risiko kejadian kardiovaskular misalnya pasien dengan hipertensi, diabetes, dislipidemia, merokok, dan obesitas.

Golongan NSAID

(Konten ini khusus untuk dokter. Registrasi untuk baca selengkapnya)

Referensi

1. Botazan NH, Furst DE. Nonsteroidal anti-Inflammatory Drugs, Disease-Modifying antirheumatic Drugs, Nonopioid analgesics, & Drugs Used in Gout . In: Katzung BG, Trevor AJ. Basic & Clinical Pharmacology, 13th ed. Mc Graw Hill. 2015: 618-21.
2. Varga Z, Sabwari SRA, Vargova V. Cardiovascular risk of nonsteroidal anti-inflammatory drugs: an under recognized public health issue. Cureus. 2017;9(4):e1144. DOI: 10.7759/cureus.1144
3. Schmidt M, Lamberts M, Olsen AMS, Fosbøll E, Niessner A, Tamargo J, et al. Cardiovascular safety of non-aspirin non-steroidal anti-inflammatory drugs: review and position paper by the working group for Cardiovascular Pharmacotherapy of the European Society of Cardiology , European Heart Journal, Volume 37, Issue 13, 1 April 2016, Pages 1015–1023, https://doi.org/10.1093/eurheartj/ehv505
4. Kearney PM, Baigent C, Godwin J, et al. Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials. BMJ. 2006;332:1302–8.
5. McGettigan P, Henry D. Cardiovascular risk with non-steroidal anti-inflammatory drugs: systematic review of population-based controlled observational studies. Plos Med. 2011;8(9):e1001098.
6. Bally M, Dendukuri N, Rich B, Nadeau L, Helin- Salmivaara A, Garbe E, et al. Risk of acute myocardial infarction with NSAIDs in real world use: bayesian meta-analysis of individual patient data. BMJ 2017;357:j1909 | doi: 10.1136/bmj.j1909.
7. Ibanez B, James S, Agewall S, Antunes MJ, Buciarelli-Ducci C, Bueno H. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2018;(39):119-77. doi:10.1093/eurheartj/ehx393
8. Paez Espinosa EV, Murad JP, Khasawneh FT. Aspirin: Pharmacology and Clinical Applications. Thrombosis. 2012;2012:173124. doi:10.1155/2012/173124.
9. Amsterdam EA, Wenger NK, Brindis RG, Casey DE, Ganiats TG,Holmes DR, et al. 2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014;130:2354–2394.
10. Gislason GH, Jacobsen S, Rasmussen JN, et al. Risk of death or reinfarction associated with the use of selective cyclooxygenase-2 inhibitors and nonselective nonsteroidal antiinflammatory drugs after acute myocardial infarction. 2006. Circulation 113:2906–2913.
11. Olsen AMS, Fosbol EL, Lindhardsen J, Folke F, Charlot M, Selmer C, et al. Long-term cardiovascular risk of nonsteroidal anti-inflammatory drug use according to time passed after first-time myocardial infarction: a nationwide cohort study. Circulation. 2012;126:1955-1963.