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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2015; 7(7): 383-391
Published online Jul 26, 2015. doi: 10.4330/wjc.v7.i7.383
Impairment of aspirin antiplatelet effects by non-opioid analgesic medication
Amin Polzin, Thomas Hohlfeld, Malte Kelm, Tobias Zeus
Amin Polzin, Malte Kelm, Tobias Zeus, Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, 40225 Dusseldorf, Germany
Thomas Hohlfeld, Institute for Pharmacology and Clinical Pharmacology, Heinrich Heine University, 40225 Dusseldorf, Germany
Author contributions: All the authors contributed to this paper.
Supported by The Forschungskommission of the Medical Faculty of the Heinrich Heine University (to AP), No. 16-2014.
Conflict-of-interest statement: The authors state that there were no conflicts of interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Med. Amin Polzin, MD, Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Dusseldorf, Moorenstrasse 5, 40225 Dusseldorf, Germany. amin.polzin@med.uni-duesseldorf.de
Telephone: +49-211-18800 Fax: +49-211-18812
Received: April 24, 2015
Peer-review started: April 26, 2015
First decision: May 13, 2015
Revised: May 28, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: July 26, 2015
Processing time: 101 Days and 14.3 Hours
Abstract

Aspirin is the mainstay in prophylaxis of cardiovascular diseases. Impaired aspirin antiplatelet effects are associated with enhanced incidence of cardiovascular events. Comedication with non-opioid analgesic drugs has been described to interfere with aspirin, resulting in impaired aspirin antiplatelet effects. Additionally, non-opioid analgesic medication has been shown to enhance the risk of cardiovascular events and death. Pain is very frequent and many patients rely on analgesic drugs to control pain. Therefore effective analgesic options without increased risk of cardiovascular events are desirable. This review focuses on commonly used non-opioid analgesics, interactions with aspirin medication and impact on cardiovascular risk.

Keywords: Non-steroidal anti-inflammatory drug; Drug-drug interaction; Pharmacodynamic; Dipyrone; Aspirin; Paracetamol; Metamizole

Core tip: Aspirin is the mainstay in prophylaxis of cardiovascular diseases. Impaired aspirin antiplatelet effects are associated with enhanced incidence of cardiovascular events. Comedication with non-opioid analgesic drugs has been described to interfere with aspirin, resulting in impaired aspirin antiplatelet effects. Additionally, non-opioid analgesic medication has been shown to enhance the risk of cardiovascular events and death. Pain is very frequent and many patients rely on analgesic drugs to control pain. Therefore effective analgesic options without increased risk of cardiovascular events are desirable. This review focuses on commonly used non-opioid analgesics, interactions with aspirin medication and impact on cardiovascular risk.