Use of non-steroidal anti-inflammatory drugs and risk of ischemic and hemorrhagic stroke in the Australian veteran community.
OBJECTIVE
Studies on the risk of stroke in users of non-steroidal anti-inflammatory drugs (NSAIDs) have provided conflicting results. We studied the association between the use of non-selective ns-NSAIDs, selective COX-2 inhibitors, or either of these NSAIDs, and the incidence of stroke-related hospitalization in elderly subjects.


METHODS
We conducted a retrospective nested case-control study on Australian veterans using nationwide hospital admission and pharmacy dispensing data. Conditional logistic regression analysis was used to estimate both crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) for the risk of events for three different measures of prescription supply exposure over the last 2 years; (1) whether supplied at least once; (2) supply frequency: supplied more than twice within the last 30 days, once or twice within the last 30 days, or once or more within 30 days to 2 years; and (3) total supplies.


RESULTS
There was a trend toward a reduced risk of ischemic stroke with any NSAID (OR 0.95, 95%CI 0.89-1.00) if supplied at least once within the last 2 years and a mildly reduced risk in those supplied any NSAID once or twice within the last 30 days (OR 0.89, 95%CI 0.81-0.98). Use of either ns-NSAIDs or selective COX-2 inhibitors were not associated with a significant change in risk.


CONCLUSIONS
The use of any NSAIDs is not associated with an increase in the risk of ischemic stroke in Australian veterans.
Mangoni
Arduino A
AA
Department of Clinical Pharmacology, School of Medicine, Flinders University, Adelaide, Australia. arduino.mangoni@flinders.edu.au
Woodman
Richard J
RJ
Gilbert
Andrew L
AL
Knights
Kathleen M
KM
D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001315:Australia / Q000453:epidemiology; D002545:Brain Ischemia / Q000139:chemically induced* / Q000453:epidemiology; D016022:Case-Control Studies; D015897:Comorbidity; D052246:Cyclooxygenase 2 Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D017891:Pharmacoepidemiology; D012189:Retrospective Studies; D012306:Risk; D020521:Stroke / Q000139:chemically induced* / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors