OBJECTIVE: The comparative risk of myocardial infarction (MI) with cyclo-oxygenase-2-specific drugs and traditional non-steroidal anti-inflammatory drugs (NSAIDs) was determined. METHODS: The results of studies of a suitable size in colonic adenoma and arthritis-that had been published in English and from which crude data about MIs could be extracted-were evaluated. Medline, Embase and Cinahl (2000-2006) databases, as well as published bibliographies, were used as data sources. Systematic reviews examined MI risks in case-control and cohort studies, as well as in randomised controlled trials (RCTs). RESULTS: 14 case-control studies (74 673 MI patients, 368 968 controls) showed no significant association of NSAIDs with MI in a random-effects model (OR 1.17; 95% CI 0.99 to 1.37) and a small risk of MI in a fixed-effects model (OR 1.32; 95% CI 1.29 to 1.35). Sensitivity analyses showed higher risks of MI in large European studies involving matched controls. Six cohort studies (387 983 patient years, 1 120 812 control years) showed no significant risk of MI with NSAIDs (RR 1.03; 95% CI 1.00 to 1.07); the risk was higher with rofecoxib (RR 1.25; 95% CI 1.17 to 1.34) but not with any other NSAIDs. Four RCTs of NSAIDs in colonic adenoma (6000 patients) showed an increased risk of MI (RR 2.68; 95% CI 1.43 to 5.01). Fourteen RCTs in arthritis (45 425 patients) showed more MIs with cyclo-oxygenase-2-specific drugs (Peto OR 1.6; 95% CI 1.1 to 2.4), but fewer serious upper gastrointestinal events (Peto OR 0.40; 95% CI 0.31 to 0.53). CONCLUSION: The overall risk of MI with NSAIDs and cyclo-oxygenase-2-specific drugs was small; rofecoxib showed the highest risk. There was an increased MI risk with cyclo-oxygenase-2-specific drugs compared with NSAIDs, but less serious upper gastrointestinal toxicity.
OBJECTIVE: The comparative risk of myocardial infarction (MI) with cyclo-oxygenase-2-specific drugs and traditional non-steroidal anti-inflammatory drugs (NSAIDs) was determined. METHODS: The results of studies of a suitable size in colonic adenoma and arthritis-that had been published in English and from which crude data about MIs could be extracted-were evaluated. Medline, Embase and Cinahl (2000-2006) databases, as well as published bibliographies, were used as data sources. Systematic reviews examined MI risks in case-control and cohort studies, as well as in randomised controlled trials (RCTs). RESULTS: 14 case-control studies (74 673 MI patients, 368 968 controls) showed no significant association of NSAIDs with MI in a random-effects model (OR 1.17; 95% CI 0.99 to 1.37) and a small risk of MI in a fixed-effects model (OR 1.32; 95% CI 1.29 to 1.35). Sensitivity analyses showed higher risks of MI in large European studies involving matched controls. Six cohort studies (387 983 patient years, 1 120 812 control years) showed no significant risk of MI with NSAIDs (RR 1.03; 95% CI 1.00 to 1.07); the risk was higher with rofecoxib (RR 1.25; 95% CI 1.17 to 1.34) but not with any other NSAIDs. Four RCTs of NSAIDs in colonic adenoma (6000 patients) showed an increased risk of MI (RR 2.68; 95% CI 1.43 to 5.01). Fourteen RCTs in arthritis (45 425 patients) showed more MIs with cyclo-oxygenase-2-specific drugs (Peto OR 1.6; 95% CI 1.1 to 2.4), but fewer serious upper gastrointestinal events (Peto OR 0.40; 95% CI 0.31 to 0.53). CONCLUSION: The overall risk of MI with NSAIDs and cyclo-oxygenase-2-specific drugs was small; rofecoxib showed the highest risk. There was an increased MI risk with cyclo-oxygenase-2-specific drugs compared with NSAIDs, but less serious upper gastrointestinal toxicity.
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: T Pincus; G Koch; H Lei; B Mangal; T Sokka; R Moskowitz; F Wolfe; A Gibofsky; L Simon; S Zlotnick; J G Fort Journal: Ann Rheum Dis Date: 2004-04-13 Impact factor: 19.103
Authors: Thomas J Schnitzer; Jannie Beier; Piet Geusens; Paul Hasler; Sanjay K Patel; Ingo Senftleber; Xavier Gitton; Alan Moore; Victor S Sloan; Gyula Poór Journal: Arthritis Rheum Date: 2004-08-15
Authors: Luis A García Rodríguez; Cristina Varas-Lorenzo; Andrew Maguire; Antonio González-Pérez Journal: Circulation Date: 2004-06-14 Impact factor: 29.690
Authors: Eduardo Collantes; Sean P Curtis; Ka Wing Lee; Noemi Casas; Timothy McCarthy; Agustin Melian; Peng L Zhao; Diana B Rodgers; Calogera L McCormick; Michael Lee; Christopher R Lines; Barry J Gertz Journal: BMC Fam Pract Date: 2002-05-22 Impact factor: 2.497
Authors: Luís A Lomba; Paulo H Vogt; Victor E P Souza; Mariane C G Leite-Avalca; Maria H Verdan; Maria Elida A Stefanello; Aleksander R Zampronio Journal: Inflammation Date: 2017-06 Impact factor: 4.092
Authors: Stephanie J Reisinger; Patrick B Ryan; Donald J O'Hara; Gregory E Powell; Jeffery L Painter; Edward N Pattishall; Jonathan A Morris Journal: J Am Med Inform Assoc Date: 2010 Nov-Dec Impact factor: 4.497
Authors: Teryl Nuckols; Philip Harber; Karl Sandin; Douglas Benner; Haoling Weng; Rebecca Shaw; Anne Griffin; Steven Asch Journal: J Occup Rehabil Date: 2011-03