COX-2 selective non-steroidal anti-inflammatory drugs and risk of serious coronary heart disease.

Ray WA, Stein CM, Daugherty JR, Hall K, Arbogast PG, Griffin MR
Lancet. 2002 360 (9339): 1071-3

PMID: 12383990 · DOI:10.1016/S0140-6736(02)11131-7

Results of premarketing and postmarketing trials have raised doubts about the cardiovascular safety of the non-steroidal anti-inflammatory drug (NSAID) rofecoxib, especially at doses greater than 25 mg. Between Jan 1, 1999, and June 30, 2001, we did a retrospective cohort study of individuals on the expanded Tennessee Medicaid programme (TennCare), in which we assessed occurrence of serious coronary heart disease (CHD) in non-users (n=202916) and in users of rofecoxib and other NSAIDs (rofecoxib n=24 132, other n=151 728). Participants were aged 50-84 years, lived in the community, and had no life-threatening non-cardiovascular illness. Users of high-dose rofecoxib were 1.70 (95% CI 0.98-2.95, p=0.058) times more likely than non-users to have CHD; among new users this rate increased to 1.93 (1.09-3.42, p=0.024). By contrast, there was no evidence of raised risk of CHD among users of rofecoxib at doses of 25 mg or less or among users of other NSAIDs.

MeSH Terms (27)

Aged Aged, 80 and over Anti-Inflammatory Agents, Non-Steroidal Celecoxib Coronary Disease Cyclooxygenase 2 Cyclooxygenase 2 Inhibitors Cyclooxygenase Inhibitors Female Humans Ibuprofen Isoenzymes Lactones Male Medicaid Membrane Proteins Middle Aged Naproxen Product Surveillance, Postmarketing Prostaglandin-Endoperoxide Synthases Pyrazoles Regression Analysis Retrospective Studies Risk Factors Sulfonamides Sulfones Tennessee

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