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In people with atrial fibrillation receiving antithrombotics, short-term non-steroidal anti-inflammatory drug exposure increases risk of serious bleeding
  1. Aung Myat
  1. The Rayne Institute, Cardiovascular Division, British Heart Foundation Centre of Research Excellence, King's College London, London, UK
  1. Correspondence to : Dr Aung Myat, Cardiovascular Division, The Rayne Institute, 4th Floor Lambeth Wing, St Thomas’ Hospital, London SE1 7EH, UK; aung.myat{at}kcl.ac.uk

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Implications for practice and research

  • Short courses of non-steroidal anti-inflammatory drugs (NSAIDs) should be used with caution in patients with atrial fibrillation (AF) already taking antithrombotic therapy for stroke prevention since there is an increased risk of serious bleeding and clot formation.

  • Research needs to be carried out on whether combined NSAID and non-vitamin K oral anticoagulant use is also associated with serious bleeding and thromboembolism.

Context

Since the discovery of salicylic acid from willow bark in the mid-19th century, a multitude of NSAIDs have been developed. They are widely used for their anti-inflammatory and analgesic properties, good tolerability and speed of action. Conversely their use can increase the risk of gastrointestinal bleeding, kidney injury, …

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