NSAID use and the risk of hospitalization for first myocardial infarction in the general population: a nationwide case-control study from Finland

To evaluate the risk of first myocardial infarction (MI) associated with the use of various non-steroidal anti-inflammatory drugs (NSAIDs) in the general population. We conducted a population-based matched case-control study over the years 2000-3 in outpatient residents of Finland. In the nationwide...

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Bibliographic Details
Published in:European heart journal 2006-07, Vol.27 (14), p.1657-1663
Main Authors: Helin-Salmivaara, Arja, Virtanen, Arja, Vesalainen, Risto, Grönroos, Juha M, Klaukka, Timo, Idänpään-Heikkilä, Juhana E, Huupponen, Risto
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Aged
Aged, 80 and over
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Case-Control Studies
Cyclooxygenase Inhibitors - adverse effects
Female
Finland - epidemiology
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Myocardial Infarction - chemically induced
Myocardial Infarction - epidemiology
Registries
Risk Assessment
Risk Factors
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Summary:To evaluate the risk of first myocardial infarction (MI) associated with the use of various non-steroidal anti-inflammatory drugs (NSAIDs) in the general population. We conducted a population-based matched case-control study over the years 2000-3 in outpatient residents of Finland. In the nationwide Hospital Discharge Register 33 309 persons with first time MI were identified. A total of 138 949 controls individually matched for age, gender, hospital catchment area, and index day were selected from the Population Register. For combined NSAIDs, the adjusted odds ratio for the risk of first MI with current use was 1.40 (95% CI, 1.33-1.48). The risk was similar for conventional (1.34; 1.26-1.43), semi-selective (etodolac, nabumetone, nimesulide, and meloxicam) (1.50; 1.32-1.71), and cyclo-oxygenase-2 (COX-2) selective NSAIDs (rofecoxib, celecoxib, valdecoxib, and etoricoxib) (1.31; 1.13-1.50). Age of current user did not consistently modify the risk. No NSAID was associated with an MI-protective effect. All durations from 1 to 180 days of conventional NSAIDs and from 31 to 90 days duration of COX-2 selective NSAIDs were associated with an elevated risk of MI. Current use of all NSAIDs is associated with a modest risk of first time MI.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/ehl053