nach oben

Journal of Thrombosis and Thrombolysis

Erschienen in:

07.11.2018

A narrative review of the cardiovascular risks associated with concomitant aspirin and NSAID use

verfasst von: Paul Gurbel, Udaya Tantry, Steven Weisman

Erschienen in: Journal of Thrombosis and Thrombolysis | Ausgabe 1/2019

Einloggen, um Zugang zu erhalten

Abstract

The concomitant use of low-dose aspirin for cardioprotection and non-steroidal anti-inflammatory agents for pain relief is prevalent, particularly in the elderly for whom cardiovascular disease and pain are common co-morbidities. Non-selective non-steroidal anti-inflammatory drugs (NSAIDs) are known to interfere with the antiplatelet effect of aspirin through competitive binding with COX-1. While the clinical significance of this interference is still unclear, this review sought to assess the body of literature which has evaluated the potential attenuation of the anti-platelet effect of aspirin when dosed concomitantly with an NSAID. This review supports that the pharmacodynamic interaction between aspirin and non-selective NSAIDs occurs, but finds that the interaction varies amongst agents, and is highly dependent on numerous factors including: dose timing, dose of aspirin, and dose of the NSAID in question. Recent findings suggest that patient factors, such as body weight may also be indicators of aspirin’s cardiovascular effectiveness. Ultimately, the clinical decision making for concomitant NSAID and low-dose aspirin regimens remains at the patient level.

Awtry EH, Loscalzo J (2000) Aspirin. Circulation 101:1206–1218CrossRefPubMed

Bibbins-Domingo K, U.S. Preventive Services Task Force (2016) Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. preventive services task force recommendation statement. Ann Intern Med 164:836–845CrossRefPubMed

Smith SC Jr et al (2011) AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation 124:2458–2473CrossRefPubMed

McNeil JJ, Nelson MR, Woods RL, ASPREE Investigator Group et al (2018) Effect of aspirin on all-cause mortality in the healthy elderly. N Engl J Med 379:1519–1528CrossRefPubMedPubMedCentral

Zhou Y, Boudreau DM, Freedman AN (2014) Trends in the use of aspirin and nonsteroidal anti-inflammatory drugs in the general U.S. population. Pharmacoepidemiol Drug Saf 23:43–50CrossRefPubMed

Sopena F, Lanas A (2007) How to advise aspirin use in patients who need NSAIDs. Curr Pharm Des 13:2248–2260CrossRefPubMed

FDA Information for Healthcare Professionals (2006) Concomitant use of ibuprofen and aspirin new information. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm. Accessed 12 Aug 2018

Farkouh ME, Greenberg JD, Jeger RV et al (2007) Cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib. Ann Rheum Dis 66:764–770CrossRefPubMedPubMedCentral

Hernandez-Diaz S, Varas-Lorenzo C, Garcia Rodriguez LA (2006) Non-steroidal antiinflammatory drugs and the risk of acute myocardial infarction. Basic Clin Pharmacol Toxicol 98:266–274CrossRefPubMed

10.

Varas-Lorenzo C, Riera-Guardia N, Calingaert B et al (2013) Myocardial infarction and individual nonsteroidal anti-inflammatory drugs meta-analysis of observational studies. Pharmacoepidemiol Drug Saf 22:559–570CrossRefPubMedPubMedCentral

11.

Yokoyama H, Ito N, Soeda S, Ozaki M, Suzuki Y, Watanabe M, Kashiwakura E, Kawada T, Yamada Y (2013) et al. Influence of non-steroidal anti-inflammatory drugs on antiplatelet effect of aspirin. J Clin Pharm Ther 38:12–15CrossRefPubMed

12.

Patrono C, García Rodríguez LA, Landolfi R, Baigent C (2005) Low-dose aspirin for the prevention of atherothrombosis. N Engl J Med 353:2373–2383CrossRefPubMed

13.

Catella-Lawson F, Reilly MP et al (2001) Cyclooxygenase inhibitors and the antiplatelet effects of aspirin. N Engl J Med 345:1809–1817CrossRefPubMed

14.

Capone ML, Sciulli MG, Tacconelli S, Grana M, Ricciotti E, Renda G, DiGregorio P, Merciaro G, Patrignani P (2005) Pharmacodynamic interaction of naproxen with low-dose aspirin in healthy subjects. J Am Coll Cardiol 45:1295–1301CrossRefPubMed

15.

Gurbel PA, Bliden KP, Zhu J, Troullos E et al (2018) Thromboxane inhibition during concurrent therapy with low-dose aspirin and over-the-counter naproxen sodium. J Thromb Thrombolysis 45:18–26CrossRefPubMed

16.

Vane JR (1971) Inhibition of prostaglandin synthesis as a mechanism of action for the aspirin-like drugs. Nature 231:232–235

17.

Sellers RS, Radi ZA, Khan NK (2010) Pathophysiology of cyclooxygenases in cardiovascular homeostasis. Vet Pathol 47:601–613CrossRefPubMed

18.

Tantry US, Mahla E, Gurbel PA (2009) Aspirin resistance. Prog Cardiovasc Dis 52:141–152CrossRefPubMed

19.

Kirkby NS, Lundberg MH, Harrington LS et al (2012) Cyclooxygenase-1, not cyclooxygenase-2, is responsible for physiological production of prostacyclin in the cardiovascular system. Proc Natl Acad Sci USA 109:17597–17602CrossRefPubMed

20.

Yu Y, Ricciotti E, Scalia R et al (2012) Vascular COX-2 modulates blood pressure and thrombosis in mice. Sci Transl Med 4:132ra154CrossRef

21.

Majed BH, Khalil RA (2012) Molecular mechanisms regulating the vascular prostacyclin pathways and their adaptation during pregnancy and in the newborn. Pharmacol Rev 64:540–582CrossRefPubMedPubMedCentral

22.

Zarraga IG, Schwarz ER (2007) Coxibs and heart disease: what we have learned and what else we need to know. J Am Coll Cardiol 49:1–14CrossRefPubMed

23.

Wallace JL (2008) Prostaglandins, NSAIDs, and gastric mucosal protection: why doesn’t the stomach digest itself? Physiol Rev 88:1547–1565CrossRefPubMed

24.

Ghosh R, Alajbegovic A, Gomes AV (2015) NSAIDs and cardiovascular diseases: role of reactive oxygen species. Oxid Med Cell Longev 2015:536962CrossRefPubMedPubMedCentral

25.

Goodman LS, Gilman A (eds) (2011) Anti-inflammatory, antipyretic, and analgesic agents; pharmacotherapy of gout. In: The pharmacological basis of therapeutics, 12th edn. Pergamon Press, New York

26.

Cheema A (2004) Should people on aspirin avoid ibuprofen? A review of the literature. Cardiol Rev 12:174–176CrossRefPubMed

27.

FitzGerald GA, Oates JA, Hawiger J et al (1983) Endogenous biosynthesis of prostacyclin and thromboxane and platelet function during chronic administration of aspirin in man. J Clin Invest 71:676–688CrossRefPubMedPubMedCentral

28.

Patrono C, Ciabattoni G, Patrignani P et al (1985) Clinical pharmacology of platelet cyclooxygenase inhibition. Circulation 72:177–184CrossRef

29.

Rao GH, Fareed J (2012) Aspirin prophylaxis for the prevention of thrombosis: expectations and limitations. Thrombosis 2012:104707CrossRefPubMedPubMedCentral

30.

Patrono C, Ciabattoni G, Pinca E, Pugliese F et al (1980) Low dose aspirin and inhibition of thromboxane B2 production in healthy subjects. Thromb Res 17:317–327CrossRefPubMed

31.

Van Ryn J, Kink-Eiband M, Kuritsch I et al (2004) Meloxicam does not affect the antiplatelet effect of aspirin in healthy male and female volunteers. J Clin Pharmacol 44:777–784CrossRefPubMed

32.

Renda G, Tacconelli S, Capone ML, Sacchetta D et al (2006) Celecoxib, ibuprofen, and the antiplatelet effect of aspirin in patients with osteoarthritis and ischemic heart disease. Clin Pharmacol Ther 80:264–274CrossRefPubMed

33.

VanHecken A, Juliano ML, Depre M, Lepeleire ID, Arnout J, Dynder A, Wildonger L, Petty KJ, Gottesdiener K, Hoon JND (2002) Effects of enteric-coated, low-dose aspirin on parameters of platelet function. Aliment Pharmacol Ther 16:1683–1688CrossRef

34.

Gurbel PA, Bliden KP, DiChiara J, Newcomer J et al (2007) Evaluation of dose-related effects of aspirin on platelet function: results from the Aspirin-Induced Platelet Effect (ASPECT) study. Circulation 115:3156–3164CrossRefPubMed

35.

Reilly IA, FitzGerald GA (1987) Inhibition of thromboxane formation in vivo and ex vivo: implications for therapy with platelet inhibitory drugs. Blood 69:180–186PubMed

36.

Rothwell PM, Cook NF, Gaziano M et al (2018) Effects of aspirin on the risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomized trials. Lancet 392:387–399CrossRefPubMedPubMedCentral

37.

Solomon D. NSAIDS (2013) Mechanism of action 2. http://www.uptodate.com/contents/nsaidsmechanism-of-action. Accessed on 10 Aug 2018

38.

Capone ML, Tacconelli S, Sciulli MG et al (2004) Clinical pharmacology of platelet, monocyte, and vascular cyclooxygenase inhibition by naproxen and low-dose aspirin in healthy subjects. Circulation 109:1468–1471CrossRefPubMed

39.

Cryer B, Berlin RG, Cooper SA et al (2005) Double-blind, randomized, parallel, placebo-controlled study of ibuprofen effects on thromboxane B2 concentrations in aspirin-treated healthy adult volunteers. Clin Ther 27:185–191CrossRefPubMed

40.

Gengo FM, Rubin L, Robson M, Rainka M et al (2008) Effects of ibuprofen on the magnitude and duration of aspirin’s inhibition of platelet aggregation: clinical consequences in stroke prophylaxis. J Clin Pharmacol 48:117–122CrossRefPubMed

41.

Gladding PA, Webster MWI, Farrell HB et al (2008) The antiplatelet effect of six non-steroidal anti-inflammatory drugs and their pharmacodynamic interaction with aspirin in healthy volunteers. Am J Cardiol 101:1060–1063CrossRefPubMed

42.

Hong Y, Gengo FM, Rainka MM et al (2008) Population pharmacodynamic modelling of aspirin- and Ibuprofen-induced inhibition of platelet aggregation in healthy subjects. Clin Pharmacokinet 47:129–137CrossRefPubMed

43.

Galliard-Grigioni KS, Reinhart WH (2009) A randomized, controlled study on the influence of acetaminophen, diclofenac, or naproxen on aspirin-induced inhibition of platelet aggregation. Eur J Pharmacol 609:96–99CrossRefPubMed

44.

Schiff M, Hochberg MC, Oldenhof J, Brune K (2009) Platelet inhibitory effects of OTC doses of naproxen sodium compared with prescription dose naproxen sodium and low-dose aspirin. Curr Med Res Opin 25:2471–2477CrossRefPubMed

45.

Oldenhof J, Hochberg M, Schiff M, Brune K (2010) Effect of maximum OTC doses of naproxen sodium or acetaminophen on low-dose aspirin inhibition of serum thromboxane B2. Curr Med Res Opin 26:1497–1504CrossRefPubMed

46.

Schuijt MP, Huntjens-Fleuren HW, de Metz M, Vollaard EJ (2009) The interaction of ibuprofen and diclofenac with aspirin in healthy volunteers. Br J Pharmacol 157:931–934CrossRefPubMedPubMedCentral

47.

Angiolillo DJ, Desai B, Hwang C et al (2011) Impact of a fixed-dose combination of naproxen and esomeprazole magnesium on serum thromboxane b2 inhibition by low-dose aspirin over 5 days in healthy adults: a phase I, randomized, double-blind, placebo-controlled, non-inferiority trial. Clin Ther 33:1883–1893CrossRefPubMed

48.

Anzellotti P, Capone ML, Jeyam A et al (2011) Low-dose naproxen interferes with the antiplatelet effects of aspirin in healthy subjects: recommendations to minimize the functional consequences. Arthritis Rheum 63:850–859CrossRefPubMed

49.

Meek IL, Vonkeman HE, Kasemier J et al (2013) Interference of NSAIDs with the thrombocyte inhibitory effect of aspirin: a placebo-controlled, ex vivo, serial placebo-controlled serial crossover study. Eur J Clin Pharmacol 69:365–371CrossRefPubMed

50.

Li X, Fries S, Li R, Lawson JA, Propert KJ et al (2014) Differential impairment of aspirin-dependent platelet cyclooxygenase acetylation by nonsteroidal antiinflammatory drugs. Proc Natl Acad Sci USA 111:16830–16835CrossRefPubMed

51.

Scheiman JM, Fendrick AM (2007) Summing the risk of NSAID therapy. Lancet 369:1580–1581CrossRefPubMed

52.

Saxena A, Balaramnavar VM, Hohlfeld T, Saxena AK (2013) Drug/drug interaction of common NSAIDs with antiplatelet effect of aspirin in human platelets. Eur J Pharmacol 721:215–224CrossRefPubMed

53.

Nalamachu S, Pergolizzi JV, Raffa RB et al (2014) Drug-drug interaction between NSAIDS and low-dose aspirin: a focus on cardiovascular and GI toxicity. Expert Opin Drug Saf 13:903–917CrossRefPubMed

54.

Fischer LM, Schlienger RG, Matter CM et al (2005) Current use of nonsteroidal antiinflammatory drugs and the risk of acute myocardial infarction. Pharmacotherapy 25:503–510CrossRefPubMed

55.

Hudson M, Baron M, Rahme E et al (2005) Ibuprofen may abrogate the benefits of aspirin when used for secondary prevention of myocardial infarction. J Rheumatol 32:1589–1593PubMed

56.

Reed GW, Abdallah M, Shao M et al ( 2017) Effect of aspirin on the cardiovascular, gastrointestinal, and renal safety of celecoxib, naproxen, or ibuprofen. American Heart Association 2017 Scientific Sessions, Anaheim

57.

Feldman M, Cryer B (1999) Aspirin absorption rates and platelet inhibition times with 325-mg buffered aspirin tablets (chewed or swallowed intact) and with buffered aspirin solution. Am J Cardiol 84:404–409CrossRefPubMed

58.

Brown N, May JA, Wilcox RG et al (1999) Comparison of antiplatelet activity of microencapsulated aspirin 162.5 mg (Caspac XL), with enteric coated aspirin 75 mg and 150 mg in patients with atherosclerosis. Br J Clin Pharmacol 48:57–62CrossRefPubMedPubMedCentral

59.

Yokoyama H, Yaguchi T, Suzuki Y et al (2012) Theoretical investigation of aspirin dosage regimen to exhibit optimal antiplatelet effects and decrease risk of upper gastrointestinal lesions. Biol Phar Bull 35:2112–2118CrossRef

Titel: A narrative review of the cardiovascular risks associated with concomitant aspirin and NSAID use
verfasst von: Paul Gurbel
Udaya Tantry
Steven Weisman
Publikationsdatum: 07.11.2018
Verlag: Springer US
Erschienen in: Journal of Thrombosis and Thrombolysis / Ausgabe 1/2019
Print ISSN: 0929-5305
Elektronische ISSN: 1573-742X
DOI: https://doi.org/10.1007/s11239-018-1764-5

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

25.04.2024 | Hypertonie | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

A narrative review of the cardiovascular risks associated with concomitant aspirin and NSAID use

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Metformin rückt in den Hintergrund

Update Innere Medizin

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2019

Correction to: Changes in treatment and outcomes after creation of a pulmonary embolism response team (PERT), a 10-year analysis

Effect of a new inhibitor of factor Xa zifaxaban, on thrombosis in the inferior vena cava in rabbits

Correction to: Direct oral anticoagulants for the treatment of venous thromboembolism in patients with active malignancy: a systematic review and meta-analysis

Elevated lipoprotein(a) as a new risk factor of cerebral venous sinus thrombosis: association with fibrin clot properties

Changes in treatment and outcomes after creation of a pulmonary embolism response team (PERT), a 10-year analysis

Does proton pump inhibition change the on-treatment anti-Xa activity in xabans-treated patients with atrial fibrillation? A pilot study

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

Adjuvante Immuntherapie verlängert Leben bei RCC

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

Metformin rückt in den Hintergrund

Update Innere Medizin