Aspirin vs. NSAIDs in the treatment of pericarditis after myocardial infarction.

For patients with idiopathic pericarditis, therapy is aimed at the relief of chest pain and inflammation. However, such treatment does nothing to prevent tamponade, constriction, or recurrent pericarditis. Nonsteroidal antiinflammatory agents (NSAIDs) are the mainstay of therapy; in observational studies, these drugs are effective in relieving chest pain in 85 to 90 percent of patients, and limited observational data suggest that the various agents have similar efficacy. Aspirin (2 to 4 g daily), indomethacin (75 to 225 mg daily), and ibuprofen (1600 to 3200 mg daily) are prescribed most often, with ibuprofen preferred, since it has a lower incidence of adverse effects than the others. Aspirin is preferable for patients who have had a recent myocardial infarction, since other NSAIDs impair scar formation in studies in animals. Indomethacin should be avoided in patients with coronary artery disease, since it diminishes coronary blood flow.

Lange, Richard A, and L D DHillis. “Clinical practice. Acute pericarditis.” The New England journal of medicine 351.21 (2004):2195-202.

In 9 of 10 patients with acute pericarditis, the cause of the disease is either viral or unknown. In the remainder of patients, pericarditis occurs after a transmural myocardial infarction, in association with other infectious agents, in conjunction with a dissecting aortic aneurysm, after blunt or sharp trauma to the chest, as a result of neoplastic invasion of the pericardium, after chest irradiation, in association with uremia, after cardiac or other thoracic surgery, in association with an inflammatory or autoimmune disorder, or as a result of taking certain pharmacologic agents

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