title: Risk of ST versus non-ST elevation myocardial infarction associated with non-steroidal anti-inflammatory drugs.
abstract: OBJECTIVE
  The objective of this study was to explore the association of non-steroidal anti-inflammatory drugs (NSAID) with ST-segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI).
  
  
  METHODS
  A matched case-control study comparing patients with incident non-fatal myocardial infarction (MI) collected by cardiologists with controls. Cases were retrieved from the Pharmacoepidemiological General Research on Myocardial Infarction (PGRx-MI) registry, a French nationwide registry consisting of 55 cardiology centres, whereas controls were selected from general practice settings. Both cases and controls were recruited from the same geographically diverse areas across continental France.
  
  
  METHODS
  The association between NSAID and MI was assessed by matched adjusted OR from conditional logistic regression.
  
  
  RESULTS
  Between 2007 and 2009, 1125 incident cases were included (67.3% and 32.7% for STEMI and NSTEMI, respectively), with 2790 controls matched to MI cases by age and sex. Current use (previous 2 months) of either diclofenac or naproxen and other arylpropionic acid NSAID was not associated with STEMI (OR 0.9, 95% CI 0.4 to 1.9 and OR 1.0, 95% CI 0.6 to 1.7, respectively), instead it showed significant association with NSTEMI (OR 2.8, 95% CI 1.2 to 6.4 and OR 0.4, 95% CI 0.2 to 0.9, respectively). Our study confirms results from previously published analyses on the association of MI with NSAID (OR 1.5, 0.9, and 1.0 for diclofenac, naproxen and related NSAID, and all NSAID combined, respectively).
  
  
  CONCLUSIONS
  Our study shows that the MI risk modification associated with NSAID is limited to NSTEMI.
authors: Equipe d’acceuil ‘Pharmacoépidémiologie et Maladies ’Infectieuses’, Institut Pasteur, Paris, France. lgrimaldi@pgrx.net
authors: Lamiae
authors: L
authors: Grimaldi-Bensouda
authors: Michel
authors: M
authors: Rossignol
authors: Nicolas
authors: N
authors: Danchin
authors: P Gabriel
authors: PG
authors: Steg
authors: Gerard
authors: G
authors: Bessede
authors: Michel
authors: M
authors: Ovize
authors: Yves
authors: Y
authors: Cottin
authors: Elisabeth
authors: E
authors: Autret-Leca
authors: Jacques
authors: J
authors: Benichou
authors: Lucien
authors: L
authors: Abenhaim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D016022:Case-Control Studies; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005260:Female; D005602:France; D006329:Heart Conduction System / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology*; D009288:Naproxen / Q000008:administration & dosage / Q000009:adverse effects*; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D009288:Naproxen