The Risk of Acute Myocardial Infarction with Etodolac Is not Increased Compared to Naproxen: A Historical Cohort Analysis of a Generic COX-2 Selective Inhibitor

Background: This study compares the risk of acute myocardial infarction among patients exposed to etodolac, naproxen, celecoxib, and rofecoxib. Methods: A retrospective cohort study in 38 258 veteran patients (26 376 patient-years) measured the adjusted odds ratios of acute myocardial infarction dur...

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Bibliographic Details
Published in:Journal of cardiovascular pharmacology and therapeutics 2008-12, Vol.13 (4), p.252-260
Main Authors: Warner, John J., Weideman, Rick A., Kelly, Kevin C., Brilakis, Emmanouil S., Banerjee, Subhash, Cunningham, Francesca, Harford, William V., Kazi, Salahuddin, Little, Bertis B., Cryer, Byron
Format: Article
Language:English
Subjects:
Aged
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Celecoxib
Cohort Studies
Cyclooxygenase 2 Inhibitors - adverse effects
Drug Utilization Review - statistics & numerical data
Drugs, Generic - adverse effects
Etodolac - adverse effects
Humans
Incidence
Lactones - adverse effects
Male
Medical Records - statistics & numerical data
Middle Aged
Myocardial Infarction - chemically induced
Myocardial Infarction - diagnosis
Myocardial Infarction - epidemiology
Naproxen - adverse effects
Prevalence
Prognosis
Pyrazoles - adverse effects
Retrospective Studies
Risk Assessment - methods
Risk Factors
Sulfonamides - adverse effects
Sulfones - adverse effects
Texas - epidemiology
Veterans - statistics & numerical data
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Summary:Background: This study compares the risk of acute myocardial infarction among patients exposed to etodolac, naproxen, celecoxib, and rofecoxib. Methods: A retrospective cohort study in 38 258 veteran patients (26 376 patient-years) measured the adjusted odds ratios of acute myocardial infarction during exposure to etodolac, naproxen, celecoxib, or rofecoxib. Results: Diagnosis of acute myocardial infarction was confirmed in 100 patients who were exposed to a study nonsteroidal anti-inflammatory drug. Compared to naproxen, the increased risk of acute myocardial infarction was not significant for etodolac (OR = 1.32, P = .27), whereas celecoxib (OR = 2.18, 95% CI 1.09-4.35, P = .03) and rofecoxib (OR = 2.16, 95 CI 1.04-4.46, P = .04) were significant. A post hoc analysis indicates that patients with a prior history of acute myocardial infarction had a significant, 4.26-fold risk for another acute myocardial infarction if taking celecoxib or rofecoxib. Conclusion: Etodolac is not associated with a statistically increased risk of acute myocardial infarction compared to naproxen.
ISSN:1074-2484
1940-4034
DOI:10.1177/1074248408323136