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Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed frequently in emergency
departments together with proton pump inhibitors to prevent gastrointestinal
complications. Such complications, peptic ulcer bleeding in particular, are among the
most serious and costly side effects of NSAID treatment. An association between
increased risk of cardiovascular events and treatment with selective cyclooxygenase
inhibitors and certain traditional NSAIDs has also been reported. This review aims to
provide an update on risk factors for gastrointestinal complications, discuss the types of
gastric lesions associated with each NSAID, analyze the implications of the cardiovascular
risk factors involved, and propose the best preventive strategy taking into account both
gastrointestinal and cardiovascular risk factors.
