NSAIDs vs. Coxibs in the Presence of Aspirin

This study is comparing the effects of two different types of anti-inflammatory pain medications — traditional NSAIDs (like ibuprofen) versus COX-2 inhibitors (called Coxibs, like celecoxib) — in patients who also take daily aspirin for heart protection, to better understand their relative risks for stomach bleeding and heart complications. **You may be eligible if...** - You are 18 to 75 years old (or 18 to 65 if you don't regularly use NSAIDs) - You have either established heart or blood vessel disease OR several risk factors for heart disease (such as high blood pressure, high cholesterol, family history, or smoking) - OR you have been diagnosed with rheumatoid arthritis requiring daily NSAID use **You may NOT be eligible if...** - You have severe kidney failure - You have serious liver disease - You have a history of stomach or intestinal bleeding - You have certain heart conditions (like recent heart attack) that make NSAID use unsafe - You are allergic to aspirin or NSAIDs - You are pregnant or breastfeeding Talk to your doctor to see if this trial is right for you.