Risk of acute myocardial infarction during use of individual NSAIDs: A nested case-control study from the SOS project.

Bibliographic Details
Title: Risk of acute myocardial infarction during use of individual NSAIDs: A nested case-control study from the SOS project.
Authors: Gwen M C Masclee, Huub Straatman, Andrea Arfè, Jordi Castellsague, Edeltraut Garbe, Ron Herings, Bianca Kollhorst, Silvia Lucchi, Susana Perez-Gutthann, Silvana Romio, René Schade, Tania Schink, Martijn J Schuemie, Lorenza Scotti, Cristina Varas-Lorenzo, Vera E Valkhoff, Marco Villa, Miriam C J M Sturkenboom
Source: PLoS ONE, Vol 13, Iss 11, p e0204746 (2018)
Publisher Information: Public Library of Science (PLoS), 2018.
Publication Year: 2018
Collection: LCC:Medicine
LCC:Science
Subject Terms: Medicine, Science
More Details: BACKGROUND:Use of selective COX-2 non-steroidal anti-inflammatory drugs (NSAIDs) (coxibs) has been associated with an increased risk of acute myocardial infarction (AMI). However, the risk of AMI has only been studied for very few NSAIDs that are frequently used. OBJECTIVES:To estimate the risk of AMI for individual NSAIDs. METHODS:A nested case-control study was performed from a cohort of new NSAID users ≥18 years (1999-2011) matching cases to a maximum of 100 controls on database, sex, age, and calendar time. Data were retrieved from six healthcare databases. Adjusted odds ratios (ORs) of current use of individual NSAIDs compared to past use were estimated per database. Pooling was done by two-stage pooling using a random effects model (ORmeta) and by one-stage pooling (ORpool). RESULTS:Among 8.5 million new NSAID users, 79,553 AMI cases were identified. The risk was elevated for current use of ketorolac (ORmeta 2.06;95%CI 1.83-2.32, ORpool 1.80; 1.49-2.18) followed, in descending order of point estimate, by indometacin, etoricoxib, rofecoxib, diclofenac, fixed combination of diclofenac with misoprostol, piroxicam, ibuprofen, naproxen, celecoxib, meloxicam, nimesulide and ketoprofen (ORmeta 1.12; 1.03-1.22, ORpool 1.00;0.86-1.16). Higher doses showed higher risk estimates than lower doses. CONCLUSIONS:The relative risk estimates of AMI differed slightly between 28 individual NSAIDs. The relative risk was highest for ketorolac and was correlated with COX-2 potency, but not restricted to coxibs.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1932-6203
Relation: http://europepmc.org/articles/PMC6211656?pdf=render; https://doaj.org/toc/1932-6203
DOI: 10.1371/journal.pone.0204746
Access URL: https://doaj.org/article/cde978a69be84d6f8d9a1fe3d2e6018d
Accession Number: edsdoj.978a69be84d6f8d9a1fe3d2e6018d
Database: Directory of Open Access Journals
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More Details
ISSN:19326203
DOI:10.1371/journal.pone.0204746
Published in:PLoS ONE
Language:English