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Effect of ibuprofen on cardioprotective effect of aspirin

T M MacDonald1, L Wei

  • 1Medicines Monitoring Unit, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital and Medical School, DD1 9SY, Dundee, UK. t.m.macdonald@dundee.ac.uk

Lancet (London, England)
|February 25, 2003
PubMed

Insights

Combining ibuprofen with low-dose aspirin may increase cardiovascular mortality risk in patients with existing cardiovascular disease. This combination therapy potentially negates aspirin

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Low-dose aspirin is widely used for cardioprotection in patients with cardiovascular disease.
  • Nonsteroidal anti-inflammatory drugs, such as ibuprofen, are commonly used for pain relief.
  • Potential interactions between aspirin and ibuprofen may affect cardiovascular outcomes.

Purpose of the Study:

  • To investigate the risk of cardiovascular mortality in patients with established cardiovascular disease taking both low-dose aspirin and ibuprofen.
  • To assess whether concomitant use of ibuprofen with aspirin impacts the cardioprotective benefits of aspirin.

Main Methods:

  • A cohort study of 7107 patients discharged after their first cardiovascular disease admission.
  • Patients were prescribed low-dose aspirin (<325 mg/day) and survived for at least one month post-discharge.
  • Comparison of mortality risk between patients using aspirin alone versus aspirin plus ibuprofen.

Main Results:

  • Patients taking aspirin plus ibuprofen showed an increased risk of all-cause mortality (adjusted hazard ratio 1.93).
  • A significantly higher risk of cardiovascular mortality was observed in the aspirin plus ibuprofen group (adjusted hazard ratio 1.73).
  • The findings suggest a potential interaction between ibuprofen and the cardioprotective effects of aspirin.

Conclusions:

  • Concomitant use of ibuprofen with low-dose aspirin is associated with increased mortality in patients with established cardiovascular disease.
  • Ibuprofen may interfere with the cardioprotective mechanisms of aspirin.
  • Clinicians should exercise caution when prescribing ibuprofen to patients on low-dose aspirin therapy for cardiovascular protection.

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