0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Potential Hazards of Adding Nonsteroidal Anti-inflammatory Drugs to Antithrombotic Therapy After Myocardial Infarction Time for More Than a Gut Check

Charles L. Campbell, MD1; David J. Moliterno, MD2
[+] Author Affiliations
1Division of Cardiovascular Medicine, University of Tennessee–Chattanooga
2Gill Heart Institute and Division of Cardiovascular Medicine, University of Kentucky, Lexington
JAMA. 2015;313(8):801-802. doi:10.1001/jama.2015.0567.
Text Size: A A A
Published online

Extract

This Viewpoint discusses potental hazards related to the concomitant use of nonsteroidal anti-inflammatory drugs and antithrombotic therapy after myocardial infarction.

Nonsteroidal anti-inflammatory drugs (NSAIDs) block prostaglandin and prostacyclin biosynthesis via their inhibition of cyclooxygenase (COX) enzymes. By inhibiting COX-1, aspirin reduces thromboxane production, and this leads to its antiplatelet effect. By more effectively inhibiting COX-2, other NSAIDs have relatively greater anti-inflammatory, antipyretic, and analgesic effects. The adverse effect profile of nonselective NSAIDs includes bleeding, particularly gastrointestinal bleeding, which is thought to result from gastric irritation, antiplatelet effects, and the loss of prostaglandin-mediated mucosal repair.1 Selective inhibitors of COX-2 were developed with the hope they would have fewer gastrointestinal adverse effects and would be highly effective against chronic inflammatory states, such as arthritis.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

3,842 Views
0 Citations
×

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
JAMAevidence.com

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Clinical Scenario

The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
Clinical Scenario

brightcove.createExperiences();