Short-term use of NSAIDs increased risk for ischemic, hemorrhagic stroke

Cardiology Today

Selective and nonselective nonsteroidal anti-inflammatory drugs, in particular ketorolac, were found to increase the risk for ischemic and hemorrhagic stroke among patients using them for the short term, according to data from a study published in Stroke.

Researchers analyzed Taiwan’s national health insurance database and identified all ischemic and hemorrhagic stroke patients (n=47,634) in 2006 who were 20 years and older. They defined the case period for each patient as 1 to 30 days before the index date and the control period as 91 to 120 days before the index date. Then, they searched for NSAID use during these periods.

The final study population consisted of 28,424 patients with ischemic stroke and 9,456 patients with hemorrhagic stroke. There was an increased risk for ischemic stroke for all oral NSAIDs with adjusted ORs ranging from 1.20 (95% CI, 1.00-1.44) for celecoxib to 1.90 (95% CI, 1.39-2.60) for ketorolac. Hemorrhagic stroke risk was notably higher for oral ketorolac (OR=2.69; 95% CI, 1.56-4.66). Additionally, researchers found an increased risk for hemorrhagic stroke with parenteral NSAIDs, in particular ketorolac, with an OR of 3.92 (95% CI, 3.25-4.72) for ischemic stroke and 5.98 (95% CI, 4.40-8.13) for hemorrhagic stroke.

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