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Efecto del ibuprofeno en el efecto cardioprotector de la aspirina
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
Resumen
La combinación de ibuprofeno con dosis bajas de aspirina puede aumentar el riesgo de mortalidad cardiovascular en pacientes con enfermedad cardiovascular existente. Esta terapia de combinación potencialmente niega el efecto de la aspirina.
Área de la Ciencia:
- Cardiología Cardiología.
- Farmacología Farmacología.
- La medicina clínica es la medicina clínica.
Sus antecedentes:
- La aspirina en dosis bajas se utiliza ampliamente para la cardioprotección en pacientes con enfermedades cardiovasculares.
- Los medicamentos antiinflamatorios no esteroideos, como el ibuprofeno, se usan comúnmente para aliviar el dolor.
- Las posibles interacciones entre la aspirina y el ibuprofeno pueden afectar los resultados cardiovasculares.
Objetivo del estudio:
- Para investigar el riesgo de mortalidad cardiovascular en pacientes con enfermedad cardiovascular establecida que toman dosis bajas de aspirina e ibuprofeno.
- Evaluar si el uso concomitante de ibuprofeno con aspirina afecta los beneficios cardioprotectores de la aspirina.
Principales métodos:
- Un estudio de cohorte de 7107 pacientes dados de alta después de su primera admisión de enfermedad cardiovascular.
- A los pacientes se les recetó una dosis baja de aspirina (<325 mg/día) y sobrevivieron durante al menos un mes después del alta.
- Comparación del riesgo de mortalidad entre los pacientes que usan aspirina sola versus aspirina más ibuprofeno.
Principales resultados:
- Los pacientes que tomaron aspirina más ibuprofeno mostraron un mayor riesgo de mortalidad por cualquier causa (proporción de riesgo ajustada de 1,93).
- Se observó un riesgo significativamente mayor de mortalidad cardiovascular en el grupo de aspirina más ibuprofeno (razón de riesgo ajustada 1.73).
- Los hallazgos sugieren una posible interacción entre el ibuprofeno y los efectos cardioprotectores de la aspirina.
Conclusiones:
- El uso concomitante de ibuprofeno con dosis bajas de aspirina se asocia con un aumento de la mortalidad en pacientes con enfermedad cardiovascular establecida.
- El ibuprofeno puede interferir con los mecanismos cardioprotectores de la aspirina.
- Los médicos deben tener precaución al prescribir ibuprofeno a pacientes en tratamiento con dosis bajas de aspirina para la protección cardiovascular.
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