Onset of acute myocardial infarction after use of non-steroidal anti-inflammatory drugs

Tarek A. Hammad, David J. Graham, Judy A. Staffa, Cynthia J. Kornegay, Gerald J. Dal Pan

Research output: Contribution to journalArticle

Abstract

Purpose: To examine the association between cyclooxygenase-2 (COX-2) selective and traditional nonsteroidal anti-inflammatory drugs (NSAIDs) and incident acute myocardial infarction (AMI), and to address unanswered questions regarding the contour of risk over time. Methods: A cohort of new NSAID users aged 40-84 years was followed for the occurrence of first AMI. Data were collected within the General Practice Research Database (GPRD) from 1 January 1997 to 31 December 2004. Results: The study population included 1 185 AMI events (889 probable and 296 possible) from a cohort of 283 136 patients. After adjustment for demographic and cardiovascular risk factors, the hazard ratio (HR) for AMI was significantly increased for both coxib (2.11, 95% corifidence interval (CI) 1.04-4.26) and non-coxib (2.24, 95%CI 1.13-4A2) COX-2 selective NSAIDs when compared to remote exposure to NSAIDs, but was not increased for traditional NSAIDs. Stratifying exposure into the first month of use versus use beyond 1 month, the risk of AMI was increased during the flrst month of COX-2 selective NSAIDs use, but not later (3.43, 95%CI 1.66-7.07 and 1.88, 95%CI 0.82-4.31, respectively p-value for interaction = 0.6). Conclusions: The results suggest that the use of coxib and non-coxib COX-2 selective NSAIDs was associated with an elevated risk of AMI within the first month of exposure. Recent past exposure to NSAID was not associated with a similar increase in risk.

Original languageEnglish (US)
Pages (from-to)315-321
Number of pages7
JournalPharmacoepidemiology and Drug Safety
Volume17
Issue number4
DOIs
StatePublished - Apr 2008
Externally publishedYes

Fingerprint

Anti-Inflammatory Agents
Myocardial Infarction
Cyclooxygenase 2
Pharmaceutical Preparations
Drug Users
General Practice
Demography
Databases
Research
Population

Keywords

  • Acute myocardial infarction
  • New user design
  • Nonsteroidal anti-inflammatory drugs

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Hammad, T. A., Graham, D. J., Staffa, J. A., Kornegay, C. J., & Dal Pan, G. J. (2008). Onset of acute myocardial infarction after use of non-steroidal anti-inflammatory drugs. Pharmacoepidemiology and Drug Safety, 17(4), 315-321. https://doi.org/10.1002/pds.1560

Onset of acute myocardial infarction after use of non-steroidal anti-inflammatory drugs. / Hammad, Tarek A.; Graham, David J.; Staffa, Judy A.; Kornegay, Cynthia J.; Dal Pan, Gerald J.

In: Pharmacoepidemiology and Drug Safety, Vol. 17, No. 4, 04.2008, p. 315-321.

Research output: Contribution to journalArticle

Hammad, TA, Graham, DJ, Staffa, JA, Kornegay, CJ & Dal Pan, GJ 2008, 'Onset of acute myocardial infarction after use of non-steroidal anti-inflammatory drugs', Pharmacoepidemiology and Drug Safety, vol. 17, no. 4, pp. 315-321. https://doi.org/10.1002/pds.1560
Hammad, Tarek A. ; Graham, David J. ; Staffa, Judy A. ; Kornegay, Cynthia J. ; Dal Pan, Gerald J. / Onset of acute myocardial infarction after use of non-steroidal anti-inflammatory drugs. In: Pharmacoepidemiology and Drug Safety. 2008 ; Vol. 17, No. 4. pp. 315-321.
@article{ba72b294567346f0aa35c8d6d050b64c,
title = "Onset of acute myocardial infarction after use of non-steroidal anti-inflammatory drugs",
abstract = "Purpose: To examine the association between cyclooxygenase-2 (COX-2) selective and traditional nonsteroidal anti-inflammatory drugs (NSAIDs) and incident acute myocardial infarction (AMI), and to address unanswered questions regarding the contour of risk over time. Methods: A cohort of new NSAID users aged 40-84 years was followed for the occurrence of first AMI. Data were collected within the General Practice Research Database (GPRD) from 1 January 1997 to 31 December 2004. Results: The study population included 1 185 AMI events (889 probable and 296 possible) from a cohort of 283 136 patients. After adjustment for demographic and cardiovascular risk factors, the hazard ratio (HR) for AMI was significantly increased for both coxib (2.11, 95{\%} corifidence interval (CI) 1.04-4.26) and non-coxib (2.24, 95{\%}CI 1.13-4A2) COX-2 selective NSAIDs when compared to remote exposure to NSAIDs, but was not increased for traditional NSAIDs. Stratifying exposure into the first month of use versus use beyond 1 month, the risk of AMI was increased during the flrst month of COX-2 selective NSAIDs use, but not later (3.43, 95{\%}CI 1.66-7.07 and 1.88, 95{\%}CI 0.82-4.31, respectively p-value for interaction = 0.6). Conclusions: The results suggest that the use of coxib and non-coxib COX-2 selective NSAIDs was associated with an elevated risk of AMI within the first month of exposure. Recent past exposure to NSAID was not associated with a similar increase in risk.",
keywords = "Acute myocardial infarction, New user design, Nonsteroidal anti-inflammatory drugs",
author = "Hammad, {Tarek A.} and Graham, {David J.} and Staffa, {Judy A.} and Kornegay, {Cynthia J.} and {Dal Pan}, {Gerald J.}",
year = "2008",
month = "4",
doi = "10.1002/pds.1560",
language = "English (US)",
volume = "17",
pages = "315--321",
journal = "Pharmacoepidemiology and Drug Safety",
issn = "1053-8569",
publisher = "John Wiley and Sons Ltd",
number = "4",

}

TY - JOUR

T1 - Onset of acute myocardial infarction after use of non-steroidal anti-inflammatory drugs

AU - Hammad, Tarek A.

AU - Graham, David J.

AU - Staffa, Judy A.

AU - Kornegay, Cynthia J.

AU - Dal Pan, Gerald J.

PY - 2008/4

Y1 - 2008/4

N2 - Purpose: To examine the association between cyclooxygenase-2 (COX-2) selective and traditional nonsteroidal anti-inflammatory drugs (NSAIDs) and incident acute myocardial infarction (AMI), and to address unanswered questions regarding the contour of risk over time. Methods: A cohort of new NSAID users aged 40-84 years was followed for the occurrence of first AMI. Data were collected within the General Practice Research Database (GPRD) from 1 January 1997 to 31 December 2004. Results: The study population included 1 185 AMI events (889 probable and 296 possible) from a cohort of 283 136 patients. After adjustment for demographic and cardiovascular risk factors, the hazard ratio (HR) for AMI was significantly increased for both coxib (2.11, 95% corifidence interval (CI) 1.04-4.26) and non-coxib (2.24, 95%CI 1.13-4A2) COX-2 selective NSAIDs when compared to remote exposure to NSAIDs, but was not increased for traditional NSAIDs. Stratifying exposure into the first month of use versus use beyond 1 month, the risk of AMI was increased during the flrst month of COX-2 selective NSAIDs use, but not later (3.43, 95%CI 1.66-7.07 and 1.88, 95%CI 0.82-4.31, respectively p-value for interaction = 0.6). Conclusions: The results suggest that the use of coxib and non-coxib COX-2 selective NSAIDs was associated with an elevated risk of AMI within the first month of exposure. Recent past exposure to NSAID was not associated with a similar increase in risk.

AB - Purpose: To examine the association between cyclooxygenase-2 (COX-2) selective and traditional nonsteroidal anti-inflammatory drugs (NSAIDs) and incident acute myocardial infarction (AMI), and to address unanswered questions regarding the contour of risk over time. Methods: A cohort of new NSAID users aged 40-84 years was followed for the occurrence of first AMI. Data were collected within the General Practice Research Database (GPRD) from 1 January 1997 to 31 December 2004. Results: The study population included 1 185 AMI events (889 probable and 296 possible) from a cohort of 283 136 patients. After adjustment for demographic and cardiovascular risk factors, the hazard ratio (HR) for AMI was significantly increased for both coxib (2.11, 95% corifidence interval (CI) 1.04-4.26) and non-coxib (2.24, 95%CI 1.13-4A2) COX-2 selective NSAIDs when compared to remote exposure to NSAIDs, but was not increased for traditional NSAIDs. Stratifying exposure into the first month of use versus use beyond 1 month, the risk of AMI was increased during the flrst month of COX-2 selective NSAIDs use, but not later (3.43, 95%CI 1.66-7.07 and 1.88, 95%CI 0.82-4.31, respectively p-value for interaction = 0.6). Conclusions: The results suggest that the use of coxib and non-coxib COX-2 selective NSAIDs was associated with an elevated risk of AMI within the first month of exposure. Recent past exposure to NSAID was not associated with a similar increase in risk.

KW - Acute myocardial infarction

KW - New user design

KW - Nonsteroidal anti-inflammatory drugs

UR - http://www.scopus.com/inward/record.url?scp=42149176039&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=42149176039&partnerID=8YFLogxK

U2 - 10.1002/pds.1560

DO - 10.1002/pds.1560

M3 - Article

C2 - 18302311

AN - SCOPUS:42149176039

VL - 17

SP - 315

EP - 321

JO - Pharmacoepidemiology and Drug Safety

JF - Pharmacoepidemiology and Drug Safety

SN - 1053-8569

IS - 4

ER -