A new study appearing this week in JAMA reports that myocardial infarction (MI) patients who are receiving antithrombotic therapy are at increased risk for bleeding, heart attack, stroke or cardiovascular death if they are also using NSAID medications. The elevated risk is apparent even after short-term use. Current guidelines recommend the administrations of dual antithrombotic therapy (aspirin and clopidogrel) for up to 12 months and one agent thereafter. Although bleeding risks associated with antithrombotic agents are increased by NSAIDs, certain NSAID agents such as ibuprofen may also impede the antithrombotic effects of aspirin and may increase risk of cardiovascular events.
An editorial accompanying the study article comments that “The cumulative evidence available is an important reminder that the while NSAIDs can be helpful and at times necessary medications for satisfactory quality of life, use of these medications among patients with a history of a recent MI is likely to be associated with clinically meaningful bleeding and ischemic risks.” Read more about the study findings here.