The benefits of aspirin in preventing heart attack have been well documented, and doctors are now urged to tell their patients who have had a heart attack, or who are at high risk for one, to take a baby aspirin (about 75 mg) daily. Many older patients take a similar medicine, nonsteroidal anti-inflammatory drugs (NSAIDs), for arthritis or other painful conditions. Since the effects of NSAIDs and aspirin on the characteristics of blood and inflammation are similar, researchers have questioned whether patients already taking NSAIDs should also take aspirin. The combination of the two drugs can theoretically lead to an increased risk of bleeding.

One recent study from Yale found that elderly Medicare patients who survived a heart attack experienced similar benefits in terms of reduced mortality in the following year when they took NSAIDs as those taking aspirin. Taking both did not increase the survival rate.

However, other experts writing in the same issue of the American Heart Journal in which that study was published questioned its methods. These experts, from Vanderbilt University School of Medicine, pointed out that other studies have found either no protective effect of NSAIDs or an effect that was smaller than that seen with aspirin.

Based on the majority of the information gathered to date, most experts continue to strongly recommend that patients at high risk for heart attack take aspirin whether or not they are already taking NSAIDs.

Related information Treatment - Medications

Sources:

• Ko D, Wang Y, Berger AK, et al. Nonsteroidal anti-inflammatory drugs after acute myocardial infarction. American Heart Journal, March 2002;143(3):475-481. (Abs.)
• Ray WA, Murray KT. Aspirin: redundant in users of nonaspirin, nonsteroidal anti-inflammatory agents? American Heart Journal, March 2002; 143(3):381-382.
• American College of Physicians/American Society of Internal Medicine. USPSTF urges patients and doctors to discuss aspirin therapy. Press release, Jan. 15, 2002.