Use of nonsteroidal anti-inflammatory drugs (NSAIDs) during acute respiratory infection may significantly increase the risk of heart attack, according to a new 7-year observational study.

The study – published in the Journal of Infectious Diseases – assessed the joint effect of respiratory infection and NSAID use on heart attack risk. Previous research into the possible link has mostly looked at these risk factors separately. The study analyzed claims from Taiwan’s National Health Insurance Program from 2005–2011, which included data from almost 10,000 patients hospitalized for a heart attack.

They found that those who were taking NSAIDs during an acute respiratory infection had a 3.4-fold increased risk for heart attack compared to patients who had neither of these risk factors. For those receiving the pain medication intravenously in the hospital, heart attack risk was even greater, at 7.2 times that of patients with neither risk factor.

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The author’s stressed that their findings do not prove a cause-and-effect relationship. They suggest that future studies could delve into which specific NSAIDs may be safer than others for patients with these infections, how illness severity affects the risks, and whether some patients may be more susceptible.

“Physicians should be aware that the use of NSAIDs during an acute respiratory infection might further increase the risk of a heart attack,” said Cheng-Chung Fang, MD, National Taiwan University Hospital and lead author. The authors hypothesized that acetaminophen may be a safer alternative, however, it was not evaluated in the study.

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  1. Wen YC, Hsiao FY, Chan KA et al. Acute respiratory infection and use of nonsteroidal anti-inflammatory drugs on risk of acute myocardial infarction: A nationwide case-crossover study. J Infect Dis. 1 February 2017. doi: 10.1093/infdis/jiw603

This article originally appeared on MPR