Takeaway
- Use of nonsteroidal anti-inflammatory drug (NSAIDs) was associated with significant risk for major bleeding, stroke/systemic embolism, and hospitalisation in patients with Afib.
- NSAIDs did not affect the safety and efficacy of twice daily dabigatran etexilate 150 and 110 mg vs warfarin.
Why this matters
- Caution should be exercised with NSAIDs use in patients with Afib who are receiving oral anticoagulants.
Study design
- This post hoc analysis of RE-LY (Randomized Evaluation of Long-Term Anticoagulant Therapy) trial included 18,113 patients with Afib.
- 2279 patients received NSAIDs at least once.
- Funding: None.
Key results
- NSAIDs use was associated with significantly higher risk for major bleeding (HR, 1.68; P<.0001) vs no use.
- NSAIDs did not significantly alter the risk for major bleeding for dabigatran etexilate 110 and 150 mg vs warfarin (Pinteraction=.93 and .63, respectively).
- Gastrointestinal major bleeding significantly increased with NSAIDs use (HR, 1.81; P<.0001).
- NSAIDs increased the risk for stroke or systemic embolism (HR, 1.50; P=.007).
- NSAIDs did not alter the efficacy of dabigatran etexilate 150 and 110 mg vs warfarin with respect to stroke/systemic embolism (Pinteraction=.59 and .54, respectively).
- Risk for myocardial infarction was not statistically different between NSAIDs and no NSAIDs groups (HR, 1.22; P=.40).
- NSAIDs use was associated with higher hospitalisation rates (HR, 1.64; P<.0001).
Limitations
- Post hoc analysis.
References
References