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Aetiology/Harm
Cohort study
NSAIDs increase bleeding risk in patients with atrial fibrillation on antithrombotic therapy
  1. Emer R McGrath
  1. Department of Neurology, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to : Dr Emer McGrath, Department of Neurology, Massachusetts General Hospital, Wang 835, 55 Fruit Street, Boston, MA 02114, USA; emcgrath2{at}partners.org

https://doi.org/10.1136/ebmed-2015-110246

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    Commentary on: Lamberts M, Lip GY, Hansen ML, et al. Relation of nonsteroidal anti-inflammatory drugs to serious bleeding and thromboembolism risk in patients with atrial fibrillation receiving antithrombotic therapy: a nationwide cohort study. Ann Intern Med 2014;161:690–8.OpenUrlCrossRefPubMedWeb of Science

    Context

    The decision to prescribe antithrombotic therapy in patients with atrial fibrillation (AF) requires a careful assessment of the competing risks of ischaemic stroke and major bleeding, most importantly intracerebral haemorrhage. Non-steroidal anti-inflammatory drugs (NSAIDs) increase the risk of haemorrhage and are included in the HAS-BLED score which predicts the 1-year risk of major bleeding in patients with AF receiving oral anticoagulant (OAC) therapy.1 NSAID use has also been associated with an increased risk of stroke and myocardial infarction.2 There is limited data available on the …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.