title: [Cardiovascular risk associated with the use of non steroidal anti-inflammatory drugs: cohort study].
abstract: BACKGROUND
  Since the clinical trial VIGOR, in which the use of rofecoxib was proved to be connected to a larger number of cardiovascular accidents, an increase of cardiovascular diseases connected to the use of non Steroidal Anti-Inflammatory Drugs has been observed. This study intends to evaluate cardiovascular impact related to the use of non steroidal anti-inflammatory drugs in a Health Care Area in Castilla La Mancha (Spain).
  
  
  METHODS
  A retrospective observational study of clinical cohort during 5 years is done in which all patients older than 18 years (n = 116 686) was included. The statistical analysis was done estimating the incidence of acute coronary syndrome in relation to the exposure time. The risk associated with the consumption of non-steroidal anti-inflammatory drugs was made by Poisson regression adjusting by sex and age. Calculation of the Daily Inhabitants Doses by means of the Defined Daily Doses, through DIGITALIS program of pharmaceutical consumption.
  
  
  RESULTS
  The connection between acute coronary syndrome and the use of anti-inflammatory drugs was positive (RR 3,64; IC95% 2,94 a 4,52; p<0,001). The cardiovascular risk was higher en alkanones (RR 18; IC95% 2,53 a 127; p=0,004), followed by propionoicos as ibuprofen (RR 2,58; IC95% 2,16 a 3,69; p<0,001), it is also the only group that is time-dependent. Thirdly arylacetic (RR 1,88; IC95% 1,6 a 2,22; p<0,001) and finally the coxib (RR 1,55; IC95% 1,25 a 1,92; p<0,001), in others antiinflammatory no increased cardiovascular risk was observed.
  
  
  CONCLUSIONS
  The use of non steroidal anti-inflammatory drugs has been connected to a higher risk of cardiovascular accidents, suggesting that not during prolonged or high-dose or should take.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Sánchez Serrano
authors.forename: José María
authors.initials: JM
authors.lastname: Tenias Burillo
authors.forename: Ángel
authors.initials: Á
authors.lastname: Arias Arias
authors.forename: María Isabel
authors.initials: MI
authors.lastname: Muñoz Carreras
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Valenzuela Gámez
mesh_terms: D054058:Acute Coronary Syndrome / Q000139:chemically induced* / Q000453:epidemiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal