Use of aspirin and ibuprofen compared with aspirin alone and the risk of myocardial infarction.
Use of aspirin and ibuprofen compared with aspirin alone and the risk of myocardial infarction.
复制标题
使用阿司匹林和布洛芬与单独使用阿司匹林相比发生心肌梗塞的风险。
DOI：
10.1001/archinte.164.8.852
复制
发表时间：
2004
影响因子：
--
通讯作者：
K. Goldberg
中科院分区：
文献类型：
--
作者：
Taral N. Patel;K. Goldberg
背景
实验室研究表明，同时使用阿司匹林和布洛芬可能会减弱阿司匹林的抗血小板作用，使其对心脏保护的作用减弱。为了确定是否有这种潜在有害相互作用的临床证据，我们进行了一项回顾性匹配病例对照研究。
方法
1990年1月1日至2000年12月31日期间在达勒姆退伍军人事务医疗中心药房开具阿司匹林或布洛芬门诊处方的所有患者均纳入本研究。同时使用阿司匹林和布洛芬的患者与仅使用阿司匹林的患者根据种族、性别、10 年内年龄以及胆固醇水平（低密度脂蛋白或总胆固醇）在 30 mg/dL (0.78 mmol/L) 以内进行匹配。然后确定每名患者的药物暴露月发生心肌梗塞的比率。
结果
约 3859 名患者同时接受了阿司匹林和布洛芬治疗，总共用药 52139 患者月。该组经历了 138 例梗塞。 10 239 名仅接受阿司匹林治疗的患者，总共使用了 156 417 患者月，出现了 684 例梗塞。发生梗塞的比率为 0.61（95% 置信区间，0.50-0.73）（P <.001），有利于同时服用阿司匹林和布洛芬的组。对糖尿病患者的分析发现比率为 0.48（95% 置信区间，0.34-0.66）（P <.001）。对两组不同时间的患者进行检查，结果显示联合使用期间的梗塞发生率比为 0.70（95% 置信区间，0.59-0.83）（P <.001）。
结论
与单独服用阿司匹林相比，同时服用阿司匹林和布洛芬的患者似乎并没有增加心肌梗塞的风险。
BACKGROUND
Laboratory investigations suggest that the simultaneous use of aspirin and ibuprofen may attenuate the antiplatelet effect of aspirin, making it less useful for cardioprotection. To determine if there is clinical evidence of this potentially harmful interaction, we conducted a retrospective matched case-control study.
METHODS
All patients issued outpatient prescriptions for aspirin or ibuprofen from January 1, 1990, to December 31, 2000, at the Durham Veterans Affairs Medical Center pharmacy were included in the study. Patients who used aspirin and ibuprofen concurrently were matched against those who used aspirin only by race, sex, age within 10 years, and cholesterol levels (either low-density lipoprotein or total cholesterol) to within 30 mg/dL (0.78 mmol/L). The rate ratio of experiencing a myocardial infarction per patient-month of drug exposure was then determined.
RESULTS
Some 3859 patients received both aspirin and ibuprofen, for a total of 52 139 patient-months of medication use. This group experienced 138 infarctions. The 10 239 patients receiving aspirin only, for a total of 156 417 patient-months of use, experienced 684 infarctions. The rate ratio of having an infarction was 0.61 (95% confidence interval, 0.50-0.73) (P <.001), favoring the group that took aspirin and ibuprofen simultaneously. An analysis of diabetic patients found a rate ratio of 0.48 (95% confidence interval, 0.34-0.66) (P <.001). An examination of patients who spent time in both groups at different times resulted in a rate ratio of infarction during combined use of 0.70 (95% confidence interval, 0.59-0.83) (P <.001).
CONCLUSION
There does not seem to be an increased risk of myocardial infarction among patients simultaneously consuming aspirin and ibuprofen compared with aspirin alone.
影响因子：
--
作者：
Solomon, DH;Glynn, RJ;Avorn, J
通讯作者：
Avorn, J
影响因子：
158.5
作者：
HENNEKENS, CH
通讯作者：
HENNEKENS, CH
美国冠状动脉疾病门诊患者中阿司匹林的使用率较低。
影响因子：
37.8
作者：
Stafford,RS
通讯作者：
Stafford,RS