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November 18, 2024European Heart JournalOpen Access

Compared with non-use, the adjusted hazard ratio for any bleeding associated with NSAID use was 2.09 (95% CI, 1.67-2.62).

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Why the study?

The bleeding risk of using non-steroidal anti-inflammatory drugs (NSAIDs) in patients treated with oral anticoagulants for venous thromboembolism (VTE) remains unclear.

Does NSAID use increase the risk of bleeding in VTE patients treated with oral anticoagulants?

Population

51 794 VTE patients initiating oral anticoagulants

Comparison

Periods with NSAID use vs periods without NSAID use

Design

Nationwide cohort study

Authors

SPSøren Riis PetersenKBKasper BonnesenEGErik Lerkevang Grove

Discussion

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Overview

NSAID use was associated with doubled bleeding risk in anticoagulated VTE patients; supports caution but leaves causal confirmation open.

Structured PICO

Does NSAID use increase the risk of bleeding in VTE patients treated with oral anticoagulants?

P
Population
51,794 patients with venous thromboembolism (VTE) initiating oral anticoagulants between 1 January 2012 and 31 December 2022 in a nationwide Danish cohort.
I
Intervention
Non-steroidal anti-inflammatory drugs (NSAIDs) (including ibuprofen, diclofenac, and naproxen) used concomitantly with oral anticoagulants.
C
Comparator
Periods without NSAID use while on oral anticoagulants.
O
Outcome
Hospital-diagnosed bleeding episodes (any bleeding).safety

Concomitant use of NSAIDs and oral anticoagulants in VTE patients significantly increases the risk of clinically relevant bleeding, including intracranial and gastrointestinal events.

Cite This Study

Petersen et al. (2024) studied this question.

synapsesocial.com/papers/69f89998bcfc91ffbfa63d1chttps://doi.org/10.1093/eurheartj/ehae736
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