"It is time to acknowledge the potential health risk of diclofenac and to reduce its use", the authors wrote.
Diclofenac is the name of a non-steroidal anti-inflammatory drug (NSAID) prescribed by doctors to treat pain, migraines, and arthritis. During the follow-up period, between 1996-2016, the scientists eliminated other risk factors for cardiovascular diseases in the subjects who participated in the study.
A 2017 study showed that the risk of heart among those who use NSAIDs is more pronounced when the drug is taken in high daily doses. According to Daily Mail, many parts of the world - including the United Kingdom - have banned diclofenac as an over-the-counter medication because of its adverse effects on the cardiovascular system.
This is not the first study to have linked diclofenac with coronary disease.
The report was conducted by researcher Morten Schmidt at Aarhus University Hospital in Denmark, and it concluded that patients should try out other NSAIDs before taking pills containing diclofenac as a last resort.
The results included data for more than 6.3 million adults in Denmark with at least one year of prescriptions.
They said in the paper: 'Treatment of pain and inflammation with NSAIDs may be worthwhile for some patients to improve quality of life despite potential side effects.
At the time, six million prescriptions were written for diclofenac, then also available over the counter. But given other research showing a similar heightened risk, the authors say it's clear that diclofenac needs to be more carefully handled, if not phased out of use completely.
Starting diclofenac was also associated with an increased rate of cardiac death compared with those taking no NSAIDs.
For those at moderate risk at the start, they found 7 extra cardiovascular events with diclofenac compared with ibuprofen or naproxen; 8 extra events compared with paracetamol; and 14 extra events compared with no NSAIDs.
For years, however, doctors have been anxious about diclofenac's potential heart risks.
The researchers pointed out the absolute risk of heart attack, stroke or other cardiovascular disease still remained low for individual patients.
However it is still available over the counter in Australia in low doses.
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. Considering its cardiovascular and gastrointestinal risks, however, there is little justification to initiate diclofenac treatment before other traditional NSAIDs.