STANLEY ROCKSON, MD: The simplest way to say yes to a question such as “Doctor, can I take an NSAID? I’m already taking low-dose aspirin?” is, if the question is posed with regard to a very self-limited problem. So somebody has a bruise or a strain related to sports, and they’re going to have a week worth of symptoms, sure, the risk of taking that drug from a cardiac standpoint is virtually zero. And it really doesn’t even need much discussion.
If, on the other hand, the patient has rheumatoid arthritis and is looking for a long-term, day-to-day solution, then the discussion needs to be a little bit more protracted, because if somebody’s going to take one of these drugs every day, then the aggregate risk to the heart, although it’s still small, goes up, and I think it requires a little more analysis of exactly how much benefit will be obtained from the NSAID, and without being able to quantitate the risk to the heart, at least to know that it’s there as an offsetting element.
