Table 17Observational studies of the cardiovascular risk with concomitant aspirin

StudyStudy DesignNumberOutcome MeasureReferentEffect (95% CI)
Any nonselective NSAIDKo 2002255Cohort39,043Mortality at 1 yearNo NSAID, no aspirinNSAID+ASA
OR 0.78 (0.69 to 0.88)
ASA alone
OR 0.81 (0.77 to 0.86)
Kurth 2003*258RCT Subgroup analysis22,071AMINo aspirin (placebo)ASA without NSAID
OR 0.56 (0.44 to 0.72)
1–59 days NSAID + ASA
OR 0.69 (0.46 to 1.0)
≥60 days NSAID + ASA
OR 1.57 (0.70 to 6.6)
Kimmel 2004254Case-control4,393First nonfatal MIAspirin aloneNSAID+ASA
OR 0.92 (0.46 to 1.9)
Fisher 2005131Case-control2,989AMINo NSAID, no aspirinNSAID+ASA
OR 0.74 (0.57 to 0.97)
ASA alone
OR 0.87 (0.75 to 1.0)
IbuprofenMacDonald 2003256Cohort7,107All-cause and cardiovascular mortalityAspirin aloneIbuprofen+ASA
All-cause mortality
HR 1.9 (1.3 to 2.9)
Cardiovascular mortality
HR 1.7 (1.0 to 2.8)
Patel 2004257Cohort14,098AMIAspirin aloneIbuprofen+ASA
OR 0.61 (0.50 to 0.73)
Kimmel 2004254Case-control4,393First nonfatal MIAspirin aloneIbuprofen+ASA
OR 2.0 (1.1 to 3.9)
Rahme 2007248Cohort76,877AMIAcetaminophen aloneIbuprofen+ASA
OR 1.4 (0.8 to 2.4)
Ibuprofen only
OR 1.0 (0.74 to 1.5)
Fischer 2005131Case-control2,989AMINo NSAID, no aspirinIbuprofen+ASA
OR 0.69 (0.42 to 1.2)

AMI = acute myocardial infarction; ASA = aspirin; CI = confidence interval; HR = hazard ratio; MI = myocardial infarction; NSAID = nonsteroidal anti-inflammatory drug; OR = odds ratio

*

Composite outcome = CV mortality, nonfatal MI, and stroke at 1 year.

From: Results

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Analgesics for Osteoarthritis: An Update of the 2006 Comparative Effectiveness Review [Internet].
Comparative Effectiveness Reviews, No. 38.
Chou R, McDonagh MS, Nakamoto E, et al.

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