Analgesic medication with dipyrone in patients with coronary artery disease: Relation to MACCE.

Abstract

BACKGROUND:

The non-opioid analgesic dipyrone can trigger life-threatening blood formation disorders. However, it is frequently used, as many patients with coronary artery disease (CAD) rely on non-opioid analgesics to relieve pain. In this study, we investigated the incidence of death, myocardial infarction (MI) or stroke in CAD patients with aspirin and dipyrone comedication as compared to aspirin-alone.

METHODS:

We conducted an observational pilot study in 72 CAD patients with aspirin ± dipyrone comedication in the department of cardiology of the University Hospital Düsseldorf. The primary end point was a composite of death, myocardial infarction (MI) or stroke. The secondary end points were the components of the primary end point. The median follow-up period was 3.2years.

RESULTS:

The primary end point occurred 67% of patients in the aspirin+dipyrone group as compared to 31% in the aspirin-alone group (odds ratio [OR] 4.5, 95% confidence interval [CI] 1.7 to 12.3; P=0.0028;). All-cause mortality was significantly higher in the aspirin+dipyrone group (44%) than the aspirin-alone group (22%; OR 2.8, 95% CI 1.01 to 7.8; P=0.049). Ischemic events (MI and stroke) were more frequent in the aspirin+dipyrone group as compared to the aspirin alone group as well (OR 4, 95% CI 1.1 to 14; P=0.03).

CONCLUSION:

In this hypothesis generating pilot analysis, dipyrone medication in aspirin treated coronary artery disease patients is associated with an increased cumulative incidence of death, MI or stroke as well as all-cause mortality and ischemic events. These data have to be confirmed in larger registries and trials.

CLINICAL TRIAL REGISTRATION:

http://clinicaltrials.gov/ct2/show/NCT01402804; Identifier: NCT01402804; Date of registration: July 25, 2011.

• Authors: Alina Achilles, Annemarie Mohring, Lisa Dannenberg, Kerstin Piayda, Bodo Levkau, Thomas Hohlfeld, Tobias Zeus, Malte Kelm, Amin Polzin
• Journal: International journal of cardiology (Int J Cardiol) Vol. 236 Pg. 76-81 (Jun 01 2017) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 28262342 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2017 Elsevier B.V. All rights reserved.

Chemical References

• Analgesics, Non-Narcotic
• Platelet Aggregation Inhibitors
• Dipyrone
• Aspirin

Topics

• Aged
• Aged, 80 and over
• Analgesics, Non-Narcotic (administration & dosage, adverse effects)
• Aspirin (administration & dosage)
• Chest Pain (drug therapy, etiology)
• Coronary Artery Disease (diagnosis, mortality, physiopathology, therapy)
• Dipyrone (administration & dosage, adverse effects)
• Drug Interactions
• Female
• Germany (epidemiology)
• Humans
• Male
• Middle Aged
• Myocardial Infarction (epidemiology)
• Pilot Projects
• Platelet Aggregation Inhibitors (administration & dosage)
• Risk Assessment
• Stroke (epidemiology)
• Treatment Outcome