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

Observational studies and in vivo experiments have raised concern that the cardioprotective effects of taking aspirin are blocked by ibuprofen, a non-steroidal anti-inflammatory drug that competitively inhibits aspirin's binding site on platelets.1 2 We determined whether prescribing aspirin and ibuprofen to patients being discharged after myocardial infarction was associated with increased risk of death. The database compiled by the Cooperative Cardiovascular Project consisted of 234 76Medicare patients in the United States who were hospitalised with a myocardial infarction between 1994 and 1996.3 We identified patients aged >=65 with myocardial infarction who were prescribed aspirin on discharge and excluded patients who had repeat admissions, had terminal illness, 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 …