BACKGROUND: Using national data (2001-2003), this study explored the risk of acute myocardial infarction (AMI), angina, stroke and transient ischaemic attack (TIA) in long-term users of rofecoxib and celecoxib in Taiwan and compared this data with that for those using meloxicam. METHODS: Patients included in the study had used celecoxib, rofecoxib or meloxicam for at least 180 days. Data were taken from National Health Insurance database for the period from 2001 to 2003. Main outcome measurements were the occurrence of AMI, angina, stroke or TIA after the initiation of long-term continuous use of these drugs. Person-time exposures and hazard ratios (HRs) were calculated based on data from 9602 eligible patients. RESULTS: In patients without a history of a cardiovascular event within the year before drug treatment began, the overall rates of AMI, angina, stroke and TIA were 1.1%, 0.6%, 2.0% and 0.6%, respectively. In those with cardiovascular events in the year before treatment began, the overall rates of AMI, angina, stroke and TIA were 5.0%, 4.8%, 6.6% and 5.8%, respectively. Compared with meloxicam users, celecoxib users had lower HRs for the development of AMI (HR 0.78, 95% CI 0.63, 0.96) and stroke (HR 0.81, 95% CI 0.70, 0.93). Rofecoxib users were at no higher risk of cardiovascular events than those receiving meloxicam. Regardless of treatment, having had a cardiovascular event in the year before treatment began played a significant role in the development of the same cardiovascular event during the prescription period; the HRs associated with having had the same cardiovascular event in the past year, versus not having had such an event, were 3.02 (95% CI 1.44, 6.32) for AMI, 5.82 (95% CI 3.19, 10.63) for angina, 2.44 (95% CI 1.79, 3.33) for stroke and 7.16 (95% CI 3.70, 13.87) for TIA. CONCLUSIONS: Patients taking celecoxib had a lower risk of cardiovascular events than those taking meloxicam. Patients taking rofecoxib were not found to be at higher cardiovascular risk than those taking meloxicam. The most significant determinant of cardiovascular risk was a history of such cardiovascular disease in the year preceding treatment initiation. Patients with a history of other medical conditions also appeared to be at higher risk of adverse cardiovascular events.
BACKGROUND: Using national data (2001-2003), this study explored the risk of acute myocardial infarction (AMI), angina, stroke and transient ischaemic attack (TIA) in long-term users of rofecoxib and celecoxib in Taiwan and compared this data with that for those using meloxicam. METHODS:Patients included in the study had used celecoxib, rofecoxib or meloxicam for at least 180 days. Data were taken from National Health Insurance database for the period from 2001 to 2003. Main outcome measurements were the occurrence of AMI, angina, stroke or TIA after the initiation of long-term continuous use of these drugs. Person-time exposures and hazard ratios (HRs) were calculated based on data from 9602 eligible patients. RESULTS: In patients without a history of a cardiovascular event within the year before drug treatment began, the overall rates of AMI, angina, stroke and TIA were 1.1%, 0.6%, 2.0% and 0.6%, respectively. In those with cardiovascular events in the year before treatment began, the overall rates of AMI, angina, stroke and TIA were 5.0%, 4.8%, 6.6% and 5.8%, respectively. Compared with meloxicam users, celecoxib users had lower HRs for the development of AMI (HR 0.78, 95% CI 0.63, 0.96) and stroke (HR 0.81, 95% CI 0.70, 0.93). Rofecoxib users were at no higher risk of cardiovascular events than those receiving meloxicam. Regardless of treatment, having had a cardiovascular event in the year before treatment began played a significant role in the development of the same cardiovascular event during the prescription period; the HRs associated with having had the same cardiovascular event in the past year, versus not having had such an event, were 3.02 (95% CI 1.44, 6.32) for AMI, 5.82 (95% CI 3.19, 10.63) for angina, 2.44 (95% CI 1.79, 3.33) for stroke and 7.16 (95% CI 3.70, 13.87) for TIA. CONCLUSIONS:Patients taking celecoxib had a lower risk of cardiovascular events than those taking meloxicam. Patients taking rofecoxib were not found to be at higher cardiovascular risk than those taking meloxicam. The most significant determinant of cardiovascular risk was a history of such cardiovascular disease in the year preceding treatment initiation. Patients with a history of other medical conditions also appeared to be at higher risk of adverse cardiovascular events.
Authors: Wayne A Ray; C Michael Stein; James R Daugherty; Kathi Hall; Patrick G Arbogast; Marie R Griffin Journal: Lancet Date: 2002-10-05 Impact factor: 79.321
Authors: Michael E Farkouh; Howard Kirshner; Robert A Harrington; Sean Ruland; Freek W A Verheugt; Thomas J Schnitzer; Gerd R Burmester; Eduardo Mysler; Marc C Hochberg; Michael Doherty; Elena Ehrsam; Xavier Gitton; Gerhard Krammer; Bernhard Mellein; Alberto Gimona; Patrice Matchaba; Christopher J Hawkey; James H Chesebro Journal: Lancet Date: 2004 Aug 21-27 Impact factor: 79.321
Authors: Robert S Bresalier; Robert S Sandler; Hui Quan; James A Bolognese; Bettina Oxenius; Kevin Horgan; Christopher Lines; Robert Riddell; Dion Morton; Angel Lanas; Marvin A Konstam; John A Baron Journal: N Engl J Med Date: 2005-02-15 Impact factor: 91.245
Authors: Stephen E Kimmel; Jesse A Berlin; Muredach Reilly; Jane Jaskowiak; Lori Kishel; Jesse Chittams; Brian L Strom Journal: Ann Intern Med Date: 2005-02-01 Impact factor: 25.391
Authors: Peter Jüni; Linda Nartey; Stephan Reichenbach; Rebekka Sterchi; Paul A Dieppe; Matthias Egger Journal: Lancet Date: 2004 Dec 4-10 Impact factor: 79.321
Authors: Rémy Chenevard; David Hürlimann; Markus Béchir; Frank Enseleit; Lukas Spieker; Matthias Hermann; Walter Riesen; Steffen Gay; Renate E Gay; Michel Neidhart; Beat Michel; Thomas F Lüscher; Georg Noll; Frank Ruschitzka Journal: Circulation Date: 2003-01-28 Impact factor: 29.690
Authors: Stephen P Motsko; Karen L Rascati; Anthony J Busti; James P Wilson; Jamie C Barner; Kenneth A Lawson; Jason Worchel Journal: Drug Saf Date: 2006 Impact factor: 5.606
Authors: Zhou Yu; Irene Crichton; Soon Yew Tang; Yiqun Hui; Emanuela Ricciotti; Mark D Levin; John A Lawson; Ellen Puré; Garret A FitzGerald Journal: Proc Natl Acad Sci U S A Date: 2012-04-09 Impact factor: 11.205
Authors: José Pedro Henriques Patrício; Jorge Pinto Pereira Barbosa; Rui Miguel Monteiro Ramos; Nuno Filipe Pimenta Antunes; Pedro Carlos Santos de Melo Journal: Clin Drug Investig Date: 2013-03 Impact factor: 2.859
Authors: R Tsutsumi; H Ito; T Hiramitsu; K Nishitani; M Akiyoshi; T Kitaori; T Yasuda; T Nakamura Journal: Rheumatol Int Date: 2007-12-14 Impact factor: 2.631
Authors: Attila Kristóf; Zoltán Husti; István Koncz; Zsófia Kohajda; Tamás Szél; Viktor Juhász; Péter Biliczki; Norbert Jost; István Baczkó; Julius Gy Papp; András Varró; László Virág Journal: PLoS One Date: 2012-12-31 Impact factor: 3.240