Results from the RE-LY study finds a concern for patients taking a prescription blood thinner. The RE-LY study is the Randomized Evaluation of Long Term Anticoagulant Therapy, as the name suggests a study on the long term affects of taking a blood thinner. The data from this study was collected from 18000 patients with atrial fibrillation over 2 years. The primary results of this study was published in 2009, this current study was a new review of the data showing an increased risk of major bleeding, stroke/SE, and hospitalization when taking an NSAID along with a blood thinner.
“In this post hoc analysis of the RE-LY study, we found that concomitant NSAID use with any anticoagulant increases extracranial risk particularly, as well as stroke risk in patients with atrial fibrillation,” reported senior author Michael Ezekowitz, MD, PhD, Thomas Jefferson University, Philadelphia, Pennsylvania to Medscape News, “Avoid NSAIDs in anticoagulated patients with atrial fibrillation.” The original study compared the effectiveness of different oral blood thinners. In this new study patients taking NSAIDs with an oral blood thinner had significantly higher rates of major bleeding than those who did not use NSAIDs. The finding was present across all blood thinner treatment groups. NSAID use was also associated with significantly more major gastrointestinal bleeding, more frequent hospitalizations, and stroke or systemic embolism.
Anticoagulants are used to thin the blood to reduce coagulation of blood and extend clotting time. These drugs are commonly used in patients with atrial fibrillation, coronary artery disease, a history of stroke, myocardial infarction, pulmonary embolism, and in patients who have a stent. There are many instances in which taking a blood thinner is important but there are might not be many instances where taking a NSAID is equally as important. The results of this study show that if you are on a blood thinner you should probably not be taking NSAID’s on a regular basis. If you take into account what we discussed in a previous blog perhaps no one should be taking an NSAID on a regular basis at all.
I want to be clear, I don’t believe that taking an NSAID for aches and/or pains every once in a while is going to elevate your risk. It is taking an NSAID on a regular, that could be daily or several times a week, for years to manage chronic pains. There are better ways to mange chronic pains without taking any medications, of course chiropractic care is one of the ways a patient can manage spine or spine related chronic pains. These studies are also a warning to younger Americans to take better care of ourselves so we don’t have to battle chronic pains when we are older. Remember the old adage, an ounce of prevention is worth a pound of cure.