Which NSAID is preferred in patients with underlying coronary artery disease risk factors?

Which NSAID is preferred in patients with underlying coronary artery disease risk factors?

• A. Ibuprofen
• B. Diclofenac
• C. Naproxen
• D. Indomethacin

Answer: (C)

In patients with coronary artery disease risk factors, choosing an NSAID with the most favorable cardiovascular safety profile is key. Among common NSAIDs, naproxen has the lowest signal for increasing heart attack or stroke risk, making it the preferred option over diclofenac or indomethacin, which show higher cardiovascular risk in studies. Ibuprofen also carries cardiovascular risk and can interfere with aspirin’s cardioprotective effect when taken together. So, if an NSAID is needed, naproxen at the lowest effective dose for the shortest duration is the safer choice, with attention to blood pressure, kidney function, and GI risk.

In patients with coronary artery disease risk factors, choosing an NSAID with the most favorable cardiovascular safety profile is key. Among common NSAIDs, naproxen has the lowest signal for increasing heart attack or stroke risk, making it the preferred option over diclofenac or indomethacin, which show higher cardiovascular risk in studies. Ibuprofen also carries cardiovascular risk and can interfere with aspirin’s cardioprotective effect when taken together. So, if an NSAID is needed, naproxen at the lowest effective dose for the shortest duration is the safer choice, with attention to blood pressure, kidney function, and GI risk.