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View Full Version : NSAIDs Double Bleeding Risk With Anticoagulants for DVT/PE



CheneyHsiung
Mon 19th May '14, 7:09pm
Source: http://www.medscape.com/viewarticle/823628?nlid=55183_1842&src=wnl_edit_medp_wir&uac=180112PN&spon=17

SEATTLE, WA — Patients receiving an anticoagulant for deep vein thrombosis (DVT) or pulmonary embolism (PE) who take a nonsteroidal anti-inflammatory drug (NSAID) or aspirin for pain or headache, even for a few days, are at heightened risk for a major bleed, according to a new study published online April 14, 2014 in JAMA Internal Medicine [1].

The researchers examined bleeding risk from aspirin or an NSAID (other than aspirin) in patients in the EINSTEIN-DVT (http://www.medscape.com/viewarticle/726312) and EINSTEIN-PE (http://www.medscape.com/viewarticle/760983) trials who were randomized to either the low-molecular-weight heparin enoxaparin followed by warfarin or acenocoumarol or to the oral anticoagulant rivaroxaban (Xarelto, Bayer/Janssen).

The trials discouraged the use of NSAIDs, yet about a quarter of the patients took them. Compared with patients who avoided these painkillers, those who took an NSAID had a 2.4-fold higher risk of a major bleed and those who took aspirin had a 1.5-fold higher risk.

CheneyHsiung
Mon 19th May '14, 7:12pm
Four score tools to evaluate the risk of bleed in clinical practice http://forum.tomhsiung.com/hematology-and-hematologists/345-four-score-tools-to-evaluate-the-risk-of-bleed-in-clinical-practice.html

The four tools are HAS-BLED score, HEMORR 2HAGES, Outpatient Bleeding Risk Index (OBRI), and Contemporary Bleeding Risk Model.