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July 28, 2005
NSAIDS and risk of MI
Citation: Hippisley-Cox J and Coupland C. Risk of myocardial infarction in patients taking cyclo-oxygenase-2 inhibitors or conventional non-steroidal anti-inflammatory drugs: Population based nested case-control analysis. BMJ 2005 Jun 11; 330:1366-9.
Outline: In this case control study in UK, a large database ( more than 7 million patients) from a general practice was used to identify 9218 cases with first myocardial infarctions and 86,349 controls ( matched for age and sex). Increased risk for MI was seen when any of these drugs were used within 3 months of MI or control index date. Diclofenac (adjusted odds ratio : 1.55) rofecoxib (adjusted odds ratio, 1.32), ibuprofen ( adjusted odds ratio 1.24) seemed to be associated with increased risk compared to nonselective NSAIDs
Comment: Many elders are on NSAIDs for chronic pain etc. Naproxen (nonselective NSAID) is sometimes easier on patients do to its BID dosing and may be possibly safer(based on this single observational study. It is to be noted that there is some evidence that some NSAIDs have a protective effective against Alzheimer's Disease ( by their effect on peroxisome proliferator g nuclear transcription factor).
Posted by VJ@stanford at July 28, 2005 10:50 AM
