UMEM Educational Pearls

Category: Cardiology

Title: NSAIDs and ACS

Keywords: NSAIDs, aspirin, acute coronary syndrome (PubMed Search)

Posted: 1/20/2008 by Amal Mattu, MD (Updated: 7/10/2020)
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Aspirin is the only NSAID that should be used in the acute treatment and also the in-hospital management of patients with STEMI or NSTEMI/unstable angina, even if the patient is chronically managed on other NSAIDs. The use of any of the non-ASA NSAIDS, both nonselective as well as COX-2 selective agents, in these patients is associated with increased risk of mortality, reinfarction, hypertension, heart failure, and myocardial rupture. Their use should be discontinued immediately at the time of admission.