Ibuprofen May Boost Heart Risk in Some Arthritis Patients

High-risk aspirin users more likely to have event taking high-dose ibuprofen

THURSDAY, April 5 (HealthDay News) -- Arthritis patients with a high risk of cardiovascular events who take high-dose ibuprofen in addition to aspirin are more likely to have a myocardial infarction or stroke than similar patients taking aspirin and a COX-2 inhibitor or naproxen, according to a report published online April 5 in the Annals of the Rheumatic Diseases.

Michael E. Farkouh, M.D., of Mount Sinai School of Medicine in New York City, and colleagues conducted a study of 18,325 osteoarthritis patients who were treated with high doses of three drugs: the cyclooxygenase-2 inhibitor lumiracoxib (400 mg once daily), ibuprofen (800 mg three times daily) or naproxen (500 mg twice daily). There were 623 patients taking ibuprofen, of whom 57 percent were also taking low-dose aspirin.

Among patients at low risk for cardiovascular disease, there was no significant difference in risk between the three treatments. However, patients at high risk of cardiovascular disease who were taking aspirin and ibuprofen had more cardiovascular mortality, non-fatal myocardial infarction and stroke at one year (eight of 373 patients) compared with those taking lumiracoxib (one of 394 patients).

"These data suggest that ibuprofen may confer an increased risk of thrombotic and congestive heart failure events relative to lumiracoxib among aspirin users at high cardiovascular risk," the authors conclude. However, they caution: "This study is subject to inherent limitations, and therefore should be interpreted as a hypothesis-generating study."

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