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Mount Sinai School of Medicine researchers have found new evidence that ibuprofen can increase the risk for osteoarthritis in patients that are already at risk to heart attack.

Researchers compared combination treatments of low-dose aspirin with drugs ibuprofen, naproxen and the cox-2 inhibitor lumircaboix. They discovered high cardiovascular risk patients that took ibuprofen and aspirin combined are nine times more likely to suffer a heart attack.

The study was published in Annals of the Rheumatic Diseases and suggests ibuprofen interferes with the blood thinning properties of aspirin in patients that are high risk candidates for cardiovascular disease.

In past studies, evidence suggested both selective cox-2 inhibitors and non-selective non-steroidal anti-inflammatory drugs (NSAIDs) increased the risk of cardiovascular episodes. However, research has lacked in high cardiovascular risk population of patients that take aspirin, in combination with pain medicines used for osteoarthritis.

Mount Sinai is amongst the first to research this area and have found that common painkiller ibuprofen, used for osteoarthritis, may boost the chances of heart problems in high cardiovascular risk patients tat are already taking aspirin.

“Ibuprofen has a significantly higher rate of major cardiovascular events, mostly heart attacks, when compared to a COX-2 inhibitor,” said Dr. Michael E. Farkouh, M.D., of Mount Sinai Heart. “The findings underscore the importance of not only considering the class of NSAIDs used in high risk cardiac patients with osteoarthritis but also making physicians aware of the interaction of NSAIDs with aspirin, diminishing any beneficial effects.”

The cardiovascular health of 18,523 patients over 50 years age with osteoarthritis were compared by researchers in the TARGET trial. Patients were taking high doses of lumiracoxib (Cox-2 inhibitor), or either of the NSAIDs- ibuprofen or naproxen.

The findings show interference of ibuprofen on the effects of aspirin in high cardiovascular risk patients.

“This is the first randomized trial evidence to show risk of interaction between ibuprofen and aspirin to be real,” said Farkouh. “Doctors should not give high risk cardiovascular patients ibuprofen for pain while they are taking aspirin for their heart. Cardiologists, rheumatologists and gastroenterologists need to work together to fully evaluate the evidence at hand to make proper recommendations to primary care physicians.”

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