PURPOSE: We examined temporal trends in NSAID use among patients referred for evaluation of suspected coronary artery disease (CAD). METHODS: We conducted a drug utilisation study using population-based healthcare data from Western Denmark, covering 3.3 million inhabitants. Three cohorts were categorised based on first-time diagnostic procedure for CAD assessment: coronary computed tomography angiography (CCTA; 2008-2022, n = 91,230), myocardial perfusion imaging (MPI; 2016-2022, n = 17,044), and all invasive coronary angiograms (ICA; 2008-2022, n = 128,327). We calculated the one-year prevalence proportion of NSAID use after the diagnostic procedures, stratified by procedure-defined CAD severity. RESULTS: NSAID use declined over the study period, regardless of CAD severity in patients undergoing CCTA or ICA (p < 0.001). In 2021, the one-year prevalence of NSAID use was 17% among patients with severe CAD vs. 24% among patients without CAD diagnosed using CCTA (prevalence proportion ratio [PPR] 0.73, 95% confidence interval [CI]: 0.60-0.90). In patients undergoing MPI, 9% of those with severe CAD vs. 15% of those with no CAD used NSAIDs (PPR 0.58, 95% CI: 0.45-0.73). In patients undergoing ICA, 10% of those with severe CAD and 20% of those with no CAD used NSAIDs (PPR 0.53, 95% CI: 0.44-0.62). CONCLUSION: Although NSAID use among patients with CAD has decreased and is lower than among patients without CAD, it remains relatively high in those with severe CAD.