Nonsteroidal anti-inflammatory drugs (NSAID) are the primary line of treatment after myocardial infarction. However, the risk of adverse clinical events associated with the use of NSAIDs is not well studied. This study aims to evaluate the cardiovascular and bleeding risks of using NSAIDs in patients with MI.

This is a nationwide cohort study that included a total of 108,232 patients (mean age 64.2 years) with first diagnosed MI. The participants were divided into two groups and assigned to receive the prescribed antithrombotic medications. The primary outcomes of the study were thromboembolic cardiovascular and clinically relevant bleeding events. The secondary outcome was the comparative risk of adverse events with subtypes of NSAIDs.

At the mean follow-up of 2.3 years, the findings suggested that NSAID treatment significantly increased the risk of cardiovascular events (HR 6.96) compared with treatment without NSAIDs. Sub-analysis of NSAIDs indicated that the risk of cardiovascular and bleeding events was the lowest with celecoxib (HR: 4.65) and meloxicam (HR: 3.03).

The research concluded that NSAID treatment was associated with a significantly higher risk of cardiovascular and bleeding events after MI. Clinicians should, therefore, avoid NSAID treatment after MI. If necessary, celecoxib and meloxicam could be considered as alternative options.

Ref: https://www.onlinejacc.org/content/76/5/518