RESEARCH - Risk of MI and death associated with the use of NSAIDs among healthy individuals

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Clin Pharmacol Ther. 2008 Nov 5.

Risk of Myocardial Infarction and Death Associated With the Use of

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) Among Healthy

Individuals: A Nationwide Cohort Study.

Fosbøl E, Gislason G, sen S, Folke F, Hansen M, Schramm T,

Sørensen R, Rasmussen J, Andersen S, Abildstrom S, Trærup J, Poulsen

H, Rasmussen S, Køber L, Torp-Pedersen C.

1Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark.

Use of some nonsteroidal anti-inflammatory drugs (NSAIDs) is

associated with increased cardiovascular risk in several patient

groups, but whether this excess risk exists in apparently healthy

individuals has not been clarified. Using a historical cohort design,

we estimated the risk of death and myocardial infarction associated

with the use of NSAIDs. Participants in the study were selected from

the Danish population and were defined as healthy according to a

history of no hospital admissions and no concomitant selected

pharmacotherapy. The source population consisted of 4,614,807

individuals, of whom 1,028,437 were included in the study after

applying selection criteria.

Compared to no NSAID use, hazard ratios (95% confidence limits) for

death/myocardial infarction were 1.01 (0.96-1.07) for ibuprofen, 1.63

(1.52-1.76) for diclofenac, 0.97 (0.83-1.12) for naproxen, 2.13

(1.89-2.41) for rofecoxib, and 2.01 (1.78-2.27) for celecoxib. A

dose-dependent increase in cardiovascular risk was seen for selective

COX-2 inhibitors and diclofenac. Caution should be exercised in NSAID

use in all individuals, and particularly high doses should be avoided

if possible.Clinical Pharmacology & #38; Therapeutics (2008); advance

online publication 5 November 2008. doi:10.1038/clpt.2008.204.

PMID: 18987620

http://www.ncbi.nlm.nih.gov/pubmed/18987620

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