The safety of acetaminophen in patients with coronary artery disease has been evaluated in a randomized, double-blind, placebo-controlled, crossover study.
A total of 33 patients with coronary artery disease received acetaminophen (1 g TID) on top of standard cardiovascular therapy for 2 weeks.
Ambulatory blood pressure, heart rate, endothelium-dependent and -independent vasodilatation, platelet function, endothelial progenitor cells, markers of the renin-angiotensin system, inflammation, and oxidative stress were determined at baseline and after each treatment period.
Treatment with acetaminophen resulted in a significant increase in mean systolic (from 122.4±11.9 to 125.3±12.0 mm Hg P=0.02 versus placebo) and diastolic (from 73.2±6.9 to 75.4±7.9 mm Hg P=0.02 versus placebo) ambulatory blood pressures.
On the other hand, heart rate, endothelial function, early endothelial progenitor cells, and platelet function did not change.
The authors have concluded that the study demonstrates for the first time that acetaminophen induces a significant increase in ambulatory blood pressure in patients with coronary artery disease.
Thus, the use of acetaminophen should be evaluated as rigorously as traditional nonsteroidal antiinflammatory drugs and cyclooxygenase-2 inhibitors, particularly in patients at increased cardiovascular risk.
http://circ.ahajournals.org/cgi/content/abstract/122/18/1789
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