Nonsteroidal anti-inflammatory drugs safe for acute myopericarditis
Use of high-dose ibuprofen and aspirin is safe for acute myopericarditis patients with normal left ventricular ejection fraction (LVEF), a study has found.
Researchers examined the medical records of 60 patients with myopericarditis who received standard heart failure therapy if indicated. There were 29 patients (62 percent; mean age, 34 years; 13 percent female; mean LVEF, 56 percent) who received NSAIDs—acetylsalicylic acid at an average daily dose of 1,300 mg or ibuprofen at an average daily dose of 1,500 mg for an mean duration of 4 weeks.
Compared with patients treated with NSAIDs, those who were not treated were older and had lower LVEF. Late gadolinium enhancement at 3 months decreased in 82 percent of the patients (14 of 17) treated with NSAIDs and in 58 percent (7 of 12) of those without NSAIDs (p=0.15).
One adverse event (3 percent) occurred in the NSAID group. The patient had an asymptomatic episode of nonsustained ventricular tachycardia on 48-hour Holter at 3-month follow-up, which lasted for 9 beats. In this case, the initial LVEF was 56 percent and follow-up MRI showed a decrease in late gadolinium enhancement.
The findings indicate that NSAIDs are a valid and safe treatment option in the setting of acute myopericarditis, researchers said.
The study is said to be the first to assess the effect of NSAIDs in myocarditis on top of standard heart failure therapy in humans. However, it is limited by the small sample size, researchers said. Large randomized clinical trials are needed to test NSAIDs prospectively for efficacy.