Why the study?
NSAIDs are commonly used medications that can potentially increase the risk of bleeding and thrombosis in anticoagulated patients.
Does NSAID use increase the risk of adverse clinical outcomes in patients with atrial fibrillation receiving oral anticoagulants?
Population
18,113 patients with AF in the RE-LY study
Comparison
NSAID use vs no NSAID use
Design
Post hoc analysis of a randomized controlled trial
Key result
Concomitant NSAID use in patients with atrial fibrillation was associated with an increased risk of major bleeding (HR 1.68; 95% CI 1.40-2.02; p<0.0001) and stroke or systemic embolism.
Authors
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May warrant caution with NSAID use in anticoagulated AF patients; leaves open whether avoidance improves outcomes.
RCT (n=18,113)
Does NSAID use increase the risk of adverse clinical outcomes in patients with atrial fibrillation receiving oral anticoagulants?
Effect estimate: HR 1.68 (95% CI 1.40 to 2.02)
p-value: p=< 0.0001
In patients with atrial fibrillation on oral anticoagulants, concomitant NSAID use is associated with significantly increased risks of major bleeding, stroke/systemic embolism, and hospitalization.
Kent et al. (2018) conducted an RCT in Atrial fibrillation (n=18,113). NSAIDs vs. No NSAID use was evaluated on Major bleeding (HR 1.68, 95% CI 1.40 to 2.02, p=< 0.0001). Concomitant NSAID use in patients with atrial fibrillation was associated with an increased risk of major bleeding (HR 1.68; 95% CI 1.40-2.02; p<0.0001) and stroke or systemic embolism.