Aspirin, ibuprofen, and mortality after myocardial infarction: retrospective cohort study

doi:10.1136/bmj.327.7427.1322

BMJ 2003;327:1322-1323 (6 December), doi:10.1136/bmj.327.7427.1322

Paper

Aspirin, ibuprofen, and mortality after myocardial infarction: retrospective cohort study

Jeptha P Curtis, clinical fellow¹, Yongfei Wang, lecturer¹, Edward L Portnay, clinical fellow¹, Frederick A Masoudi, assistant professor of medicine², Edward P Havranek, associate professor of medicine², Harlan M Krumholz, professor of medicine¹

¹ Section of Cardiovascular Disease, Department of Internal Medicine, Yale University School of Medicine, Room I-456 SHM, 333 Cedar Street, PO Box 208088, New Haven CT 06520-8088, USA, ² Division of Cardiology, MC 0960, Denver Health Medical Center, 777 Bannock Street, Denver CO 80204, USA

Correspondence to: H M Krumholz harlan.krumholz@yale.edu

The first 150 words of the full text of this article appear below.

Introduction

Observational studies and in vivo experiments have raised concernthat the cardioprotective effects of taking aspirin are blockedby ibuprofen, a non-steroidal anti-inflammatory drug that competitivelyinhibits aspirin's binding site on platelets.^1
2 We determinedwhether prescribing aspirin and ibuprofen to patients beingdischarged after myocardial infarction was associated with increasedrisk of death.

Participants, methods, and results

The database compiled by the Cooperative Cardiovascular Projectconsisted of 234 769 Medicare patients in the United Stateswho were hospitalised with a myocardial infarction between 1994and 1996.³ We identified patients aged $>=$ 65 withmyocardial infarction who were prescribed aspirin on dischargeand excluded patients who had repeat admissions, had terminalillness, had incomplete drug records, or had been transferred.The outcome measure was time to death within a year of discharge,which we ascertained from the Medicare enrolment database.⁴We compared the baseline characteristics of patients prescribedonly aspirin, prescribed aspirin and ibuprofen, and prescribed. . . [Full text of this article]

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