Most Read Articles
Pearl Toh, 3 days ago
A latest study at ISC 2019 shows that even patients with large-core stroke damage can have a good outcome after mechanical clot removal with endovascular thrombectomy (EVT), depending on the size of the infarct and time lapses between stroke onset and treatment.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
24 Aug 2016

Roshini Claire Anthony spoke with Adjunct Associate Professor Gamaliel Tan, head and senior orthopaedic consultant at Ng Teng Fong Hospital in Singapore, on how GPs can help diagnose and treat lower back pain.

Rachel Soon, 12 Dec 2018

MIMS Pharmacist presents an overview of superoxide dismutase (SOD) and its role in resisting the effects of oxidative stress and aging.

NSAID use ups risk of major bleeding, stroke in patients with atrial fibrillation

19 Jul 2018

Nonsteroidal anti-inflammatory drugs (NSAIDs) appear to increase the risk of major bleeding, stroke or systemic embolism, and hospitalization among patients with atrial fibrillation (AF), suggest the results of the RE-LY* trial. Moreover, there is no difference in the safety and efficacy of dabigatran etexilate (DE) 150 and 110 mg twice daily relative to warfarin.

A total of 18,113 patients were included in the RE-LY study, of which 2,279 used NSAIDs at least once during the trial. NSAID users had significantly elevated major bleeding (hazard ratio [HR], 1.68; 95 percent CI, 1.40–2.02; p<0.0001). NSAID vs warfarin use did not significantly alter the risk of major bleeding for DE 150 or 110 mg twice daily (p=0.63 and p=0.93 for interaction, respectively).

NSAID use significantly elevated gastrointestinal major bleeding (HR, 1.81; 1.35–2.43; p<0.0001) and the rate of stroke or systemic embolism (HR, 1.50; 1.12–2.01; p=0.007), but it did not significantly alter the relative efficacy on stroke or systemic embolism for DE 150 or 110 mg twice daily relative to warfarin (p=0.59 and p=0.54 for interaction, respectively).

Rates of myocardial infarction were comparable between NSAID use and no NSAID use (HR, 1.22; 0.77–1.93; p=0.40). Furthermore, NSAID use resulted in frequently more hospitalizations (HR, 1.64; 1.51–1.77; p<0.0001).

The authors performed a posthoc analysis of NSAIDs in the RE-LY trial, which compared DE 150 and 110 mg twice daily with warfarin in patients with AF. Clinical outcomes were assessed using treatment-independent, multivariate-adjusted Cox regression analysis by comparing NSAID use with no NSAID use. Interaction analysis was obtained from treatment-dependent Cox regression modelling, and time-varying covariate analysis for NSAID use was applied to the Cox model.

*Randomized Evaluation of Long Term Anticoagulant Therapy

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Most Read Articles
Pearl Toh, 3 days ago
A latest study at ISC 2019 shows that even patients with large-core stroke damage can have a good outcome after mechanical clot removal with endovascular thrombectomy (EVT), depending on the size of the infarct and time lapses between stroke onset and treatment.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
24 Aug 2016

Roshini Claire Anthony spoke with Adjunct Associate Professor Gamaliel Tan, head and senior orthopaedic consultant at Ng Teng Fong Hospital in Singapore, on how GPs can help diagnose and treat lower back pain.

Rachel Soon, 12 Dec 2018

MIMS Pharmacist presents an overview of superoxide dismutase (SOD) and its role in resisting the effects of oxidative stress and aging.