Diclofenac is a medicine that reduces inflammation and pain.
Diclofenac is a NSAID used for treatment of pain and inflammation with the brand names Voltaren, Cataflam and Zipsor.
In fact, according to the National Institutes of Health (NIH), about 30 million people in the United States take NSAIDs each year.
However, due to ethical concerns, these risks can not be evaluated in clinical trials. Still, authors said other non-steroidal anti-inflammatory drugs should be considered before the use of Diclofenac. The researchers looked at records between 1996 and 2006.
The European Society of Cardiology therefore carried out an extensive review of existing research that concluded that nonaspirin NSAIDs should not be prescribed to individuals at high risk of heart disease, nor should they be sold over the counter without issuing an "appropriate warning of their frequent cardiovascular complications".
During the study period, the researchers examined the cardiovascular risks of taking up diclofenac and compared them with the risks of starting paracetamol, ibuprofen, or naproxen.
This is not the first study to have linked diclofenac with coronary disease. The average age of participants was 46-49 years among those beginning NSAIDs and 56 years among those starting paracetamol.
"Treatment of pain and inflammation with NSAIDs may be of value to some patients to improve their quality of life despite possible side effects".
Those who started used diclofenac were likewise found to have a higher risk of upper gastrointestinal bleeding than those who started ibuprofen or paracetamol, and those who did not take NSAIDs.
The researchers advised that diclofenac should come with front of package warnings about its risks after the study found that patients who started diclofenac were at a 50% increased risk of cardiovascular events - such as heart failure, heart attack or atrial fibrillation - in the 30 days after starting the drug compared with those not taking the drug.
"In our study, we found that diclofenac initiators were at increased risk of major adverse cardiovascular events - both compared with no NSAID initiation, initiation of paracetamol as an analgesic alternative to NSAIDs, as well as initiation of other traditional NSAIDs", the authors wrote in the British Medical Journal.
While the researchers did acknowledge this was an observational study, they also noted the sample sizes they used were larger than what has been used with previous research on the same subject.