The new study was carried out at Yale University in the United States. Investigators used a Medicare database to identify 66,739 patients aged 65 or older who had been prescribed low-dose aspirin alone, or with ibuprofen (844 patients) or another NSAID (2,733 patients), when they were discharged from hospital following a myocardial infarction. They then compared the number of patients in each group who had died during the following year.

Overall, 17.5% of patients prescribed only aspirin, 14% of those prescribed aspirin and ibuprofen, and 15.8% of those prescribed aspirin and another NSAID, died within a year. After adjustment for risk factors such as medical history, there was no statistically significant difference between the groups in the risk of death (hazard ratio for ibuprofen plus aspirin vs. aspirin alone 0.84; CI95% 0.70, 1.01).

The BMJ commentary notes that two other observational studies have reported an increased risk among people taking both aspirin and regular (but not intermittent) ibuprofen, but points out that both suffer from a small sample size and other methodological weaknesses. The latest study also has its problems - for example, it did not account for use of over-the-counter drugs. With these misgivings, the authors say it is not yet possible to make a definitive recommendation about the use of ibuprofen by people taking prophylactic aspirin. Until firm evidence becomes available, they conclude, efficacy and the risk of bleeding should determine the choice of analgesic and anti-inflammatory medication.

Contact us
For more information.