Ibuprofen and Aspirin Combination Increase rate of Heartattacks

Ibuprofen may abrogate the benefits of aspirin when used for secondary prevention of myocardial infarction.M Hudson, M Baron, E Rahme, L PiloteJ Rheumatol 2005 8;32(8):1589-93\

From Biocritique.com

The paper by Catella-Lawson (NEJM-2001) first alerted us to the potential interaction of ibuprofen and aspirin with the potential of increased cardiac events. MacDonald (Lancet-2003) in a meta-analysis of over 7000 patients showed that ibuprofen in combination with aspirin resulted in an increase in cardiovascular mortality. This retrospective cohort study of a government database by Hudson et al identified patients over the age of 65 who had suffered an acute myocardial infarction (MI). Over a seven year period over 18,000 patients were followed and the outcome reported was the rate of recurrent MI within one year following dismissal. Of the group followed there were 1239 patients on prescription naproxen and 372 patients on prescription ibuprofen. All were on low dose aspirin for secondary cardiac prophylaxis. Hudson et al reported an increased rate of recurrent MI in the patients on ibuprofen and a decreased rate of recurrent MI in the patients on naproxen compared to those on aspirin alone. The hazard ratio was increased with the duration of exposure. Recent studies have shown that there are differences in the cardiovascular event rates among the various NSAIDs and COX-2 specific agents. However, in general the public and many health care professionals are unaware of the potential loss of cardio protection when combining ibuprofen and aspirin as well as the increased risk of major gastrointestinal complications when low dose aspirin is used in combination with any NSAID or COX-2 specific agent.

Arthur L. Weaver MD, MS