Mechanisms of the optimal protective effects of ibuprofen in acute myocardial ischemia.

Ibuprofen in doses from 3.12 to 12.5 mg/kg effectively preserve ischemic myocardial tissue in acute myocardial ischemia. The mechanisms for this protective effect do not appear to be primarily related to reducing afterload or rate (ie, curtailing myocardial oxygen demand) or to a profound antiarrhythmic effect. Rather, ibuprofen in doses that protect in acute MI, appears to 1) inhibit generation of thromboxanes, 2) stabilize lysosomal membranes, and 3) dilate the coronary vasculature. These actions may account for the ability of ibuprofen to protect in ischemia, in contrast to other nonsteroidal anti-inflammatory agents (eg, aspirin, indomethacin, meclofenamate), which fail to protect in this life-threatening disorder.