Table 7

Evidence of association between MI risk and current use of NSAIDs

n trials

outcome /

total

Celecoxib

Naproxen

Diclofenac

Ibuprofen

Review of RCTs

(population)

n*

ratio$

95%CI

n*

ratio$

95%CI

n*

ratio$

95%CI

n*

ratio$

95%CI

n*

ratio$

95%CI







Kearney 2006[3]

121 RCTs

vascular events

-

0.92

0.7, 1.3

-

1.63

1.1, 2.4

-

1.51

1.0, 2.3

combined COX2s

MI

113

1.86

1.3, 2.6

41 celecoxib trials

MI

44

>1.8

p < 0.05

Salpeter 2006[12]

13 RCTs

CV events

33

1.3

0.8, 2.1

6 naproxen trials

(joint disease)

2

0.7

0.2, 2.5

2 naproxen trials

(Alzheimer)

26

1.5

0.9, 3.0

White 2007[10]

39 RCTs

nonfatal MI

(adjudicated)

5

1.56

0.2, 11.9

(non-adjudicated)

7

1.24

0.3, 5.8

Chen 2008[5]

40 celecoxib trials

MI and CV events

5 placebo control

(at least 1 event)

1.10

0.4, 3.5

4 placebo control

(200mg/day)

0.85

0.2, 3.2

3 placebo control

(400mg/day)

2.98

0.6, 14.7

2 placebo control

(800mg/day)

1.04

0.2, 7.5

Solomon 2008[48]

6 RCTs

Composite CV event

(overall adjusted)

101

1.7

1.1, 2.3

(400 mg QD)

30

1.1

0.6, 2.0

(200 mg Bid)

38

1.8

1.1, 3.1

(400 mg Bid)

33

3.1

1.5, 6.1


aOR = adjusted odds ratio; aRR = adjusted rate ratio

TCEs = thromboembolic cardiovascular events; CD = cardiac/coronary heart disease death; AMI = acute myocardial infarction; MI = myocardial infarction; re MI = recurrent MI; HF = heart failure; CV = cardiovascular events

(cc) = (community control); (hc) = (hospital control); RCTs = randomized controlled trials

* n: number of exposed subjects with outcome

- not reported

+ range of adjusted odds ratios in 4 drug supplies categories: 1~4, 5~10, 11~19, > 20 NSAID supplies in last 2 years

$ ratio could be either one of RR(rate ratio), OR (odds ratio), or HR(hazard ratio)

Shau et al. BMC Cardiovascular Disorders 2012 12:4   doi:10.1186/1471-2261-12-4

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