- Email: [email protected]
NSAID TREATMENT IS ASSOCIATED WITH PERSISTENTLY INCREASED RISK OF DEATH IN PATIENTS WITH PRIOR MYOCARDIAL INFARCTION: A NATIONWIDE STUDY
E1027 JACC April 5, 2011 Volume 57, Issue 14
MYOCARDIAL ISCHEMIA AND INFARCTION NSAID TREATMENT IS ASSOCIATED WITH PERSISTENTLY INCREASED RISK OF DEATH IN PATIENTS WITH PRIOR MYOCARDIAL INFARCTION: A NATIONWIDE STUDY ACC Poster Contributions Ernest N. Morial Convention Center, Hall F Monday, April 04, 2011, 9:30 a.m.-10:45 a.m.
Session Title: Acute Myocardial Infarction -- Other Abstract Category: 3. Acute Myocardial Infarction—Therapy Session-Poster Board Number: 1072-307 Authors: Anne-Marie Schjerning Olsen, Emil L. Fosbøl, Jesper Lindhardsen, Fredrik Folke, Mette Charlot, Jonas B. Olesen, Peter R. Hansen, Lars Køber, Christian Torp-Pedersen, Gunnar H. Gislason, Department of Cardiology, Copenhagen University Hospital, Gentofte, Hellerup, Denmark, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark Background: Though studies have reported an increased cardiovascular risk with most non-steroidal anti-inflammatory drugs (NSAIDs), little is known about the risk profile over time following a myocardial infarction (MI). We analyzed the risk of death associated with NSAIDs in relation to the time elapsed after MI. Methods: Patients aged 30 years or older admitted with first-time MI 1997-2006 and subsequent NSAID use were identified by individual-level linkage of nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark. Risk of death related to NSAID use up to 5 years after MI was analyzed by adjusted multivariable Cox proportional-hazard models. Incidence rates of death per 10,000 person-years were calculated for individual NSAIDs. Results: Of 83,675 patients included,35,405(42%) received NSAIDs. There were 29,234 deaths (35%) during the observation period.There was a persistently increased risk of death over time associated with use of NSAIDs (Figure). Results from the Cox regression analysis showed an increased relative risk of death over time in patients receiving any individual NSAID (not shown), in particular for diclofenac (hazard ratio [HR] 1.8; 95% confidence interval [CI] 1.5 -2.1 after 1 year and HR 3.5; CI 2.7-4.6 after 5 years) and rofecoxib (HR 1.2; CI 0.8-1.6 after 1 year and HR 2.0; CI 1.4-2.9 after 5 years). Conclusion: NSAIDs are associated with persistent increase in risk of death after MI. Long-term caution with use of NSAIDs is advised after MI.
MYOCARDIAL ISCHEMIA AND INFARCTION NSAID TREATMENT IS ASSOCIATED WITH PERSISTENTLY INCREASED RISK OF DEATH IN PATIENTS WITH PRIOR MYOCARDIAL INFARCTION: A NATIONWIDE STUDY ACC Poster Contributions Ernest N. Morial Convention Center, Hall F Monday, April 04, 2011, 9:30 a.m.-10:45 a.m.
Session Title: Acute Myocardial Infarction -- Other Abstract Category: 3. Acute Myocardial Infarction—Therapy Session-Poster Board Number: 1072-307 Authors: Anne-Marie Schjerning Olsen, Emil L. Fosbøl, Jesper Lindhardsen, Fredrik Folke, Mette Charlot, Jonas B. Olesen, Peter R. Hansen, Lars Køber, Christian Torp-Pedersen, Gunnar H. Gislason, Department of Cardiology, Copenhagen University Hospital, Gentofte, Hellerup, Denmark, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark Background: Though studies have reported an increased cardiovascular risk with most non-steroidal anti-inflammatory drugs (NSAIDs), little is known about the risk profile over time following a myocardial infarction (MI). We analyzed the risk of death associated with NSAIDs in relation to the time elapsed after MI. Methods: Patients aged 30 years or older admitted with first-time MI 1997-2006 and subsequent NSAID use were identified by individual-level linkage of nationwide registries of hospitalization and drug dispensing from pharmacies in Denmark. Risk of death related to NSAID use up to 5 years after MI was analyzed by adjusted multivariable Cox proportional-hazard models. Incidence rates of death per 10,000 person-years were calculated for individual NSAIDs. Results: Of 83,675 patients included,35,405(42%) received NSAIDs. There were 29,234 deaths (35%) during the observation period.There was a persistently increased risk of death over time associated with use of NSAIDs (Figure). Results from the Cox regression analysis showed an increased relative risk of death over time in patients receiving any individual NSAID (not shown), in particular for diclofenac (hazard ratio [HR] 1.8; 95% confidence interval [CI] 1.5 -2.1 after 1 year and HR 3.5; CI 2.7-4.6 after 5 years) and rofecoxib (HR 1.2; CI 0.8-1.6 after 1 year and HR 2.0; CI 1.4-2.9 after 5 years). Conclusion: NSAIDs are associated with persistent increase in risk of death after MI. Long-term caution with use of NSAIDs is advised after MI.