NSAID Use Linked to Cardiovascular, Bleeding Events Post-MI

For patients with myocardial infarction (MI), nonsteroidal anti-inflammatory drug (NSAID) treatment is associated with a significantly increased risk for cardiovascular and bleeding events, according to a study published in the Aug. 4 issue of the Journal of the American College of Cardiology.

Dong Oh Kang, MD, from Korea University Guro Hospital in Seoul, and colleagues conducted a nationwide cohort study to examine the risk for cardiovascular and bleeding events according to prescribed antithrombotic medications. A total of 108,232 patients with first diagnosed MI were enrolled and divided into groups based on prescribed antithrombotic medications.

The researchers found that compared with no NSAID treatment, concomitant NSAID treatment significantly increased the risk for cardiovascular events and bleeding events (hazard ratios, 6.96 and 4.08, respectively). The risk for cardiovascular and bleeding events was lowest with the use of celecoxib (hazard ratios, 4.65 and 3.44, respectively) and meloxicam (hazard ratios, 3.03 and 2.80, respectively) among NSAID subtypes.

“Prescribing NSAIDs to patients with histories of MI is likely to cause potential harm; therefore, addressing the actual risk of NSAID treatment after MI is nearly impossible by randomized clinical trials because of ethical issues,” the authors write. “The present study provides crucial evidence on subjects who are difficult to include in randomized clinical trials.”

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