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


RESULTS
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.


CONCLUSIONS
Current use of all NSAIDs is associated with a modest risk of first time MI.
Helin-Salmivaara
Arja
A
Centre for Pharmacotherapy Development and Postgraduate School of Clinical Drug Research, University of Turku, PB 55, FIN-00301 Helsinki, Finland. arja.helin-salmivaara@rohto.fi
Virtanen
Arja
A
Vesalainen
Risto
R
Grönroos
Juha M
JM
Klaukka
Timo
T
Idänpään-Heikkilä
Juhana E
JE
Huupponen
Risto
R
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016022:Case-Control Studies; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000453:epidemiology; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors