心血管预后的新用户coxibs和非甾体类抗炎药物:高危组和时间的风险。

文章的细节

引用

复制到剪贴板

所罗门DH Avorn J,斯特姆苹果T,格林RJ Mogun H, Schneeweiss年代

心血管预后的新用户coxibs和非甾体类抗炎药物:高危组和时间的风险。

关节炎感冒。2006年5月,54 (5):1378 - 89。

PubMed ID

16645966 (在PubMed

]

文摘

目的:关于治疗心血管疾病风险的争议依然存在,选择性环氧合酶2抑制剂(coxibs)和非选择性非甾体类抗炎药(非甾体抗炎药)。本研究进行检查,在一大群coxibs新用户和非甾体抗炎药、心血管事件,他们的时间进程,基线心血管风险是否修改率比率(RRs)为未来事件。这个队列研究方法:包括医疗保险受益人参加一个官方处方药计划,完全覆盖非甾体类抗炎药和coxibs没有限制。所有研究患者开始使用coxib或非甾体抗炎药后1月1日,1999年。主要复合终点是心肌梗死或缺血性中风住院。预定义的暴露组包括3 coxibs可用在研究期间在美国(塞来昔布、万络和valdecoxib),以及口服双氯芬酸的配方、布洛芬、萘普生、复合其他非甾体抗炎药。我们比较的速度与每一个相关的心血管事件代理与参照组的患者不使用非甾体抗炎药或coxibs,但开始其他药物与心血管风险无关。每天暴露在所有研究药物评估基于处方数据。Cox比例风险模型分层日历年,包括其他基线心血管风险因素构成了主要的分析。结果:我们确定了74838个用户的非甾体抗炎药或coxibs,和23532年相比其他药物组成的用户参考。 Adjusted models demonstrated a significant elevation in the event rate for rofecoxib (RR 1.15, 95% confidence interval [95% CI] 1.06-1.25) and a significant reduction in the rate for naproxen (RR 0.75, 95% CI 0.62-0.92). No other coxib or NSAID was associated with a significant increase or decrease in cardiovascular event rate. The increased rate associated with rofecoxib was seen in the first 60 days of use (adjusted RR 1.14, 95% CI 1.01-1.29) and thereafter (adjusted RR 1.14, 95% CI 1.02-1.28). Kaplan-Meier event curves showed a similar pattern of risk (early and persistent separation of the event curves) among long-term rofecoxib users at low or high baseline cardiovascular risk. CONCLUSION: We found an increased cardiovascular event rate among users of rofecoxib, and a decreased rate with naproxen use. Other coxibs and NSAIDs did not appear to be associated with a difference in event rate compared with users of other drugs. The increase in rate associated with rofecoxib was seen within the first 60 days and persisted. There was no important modification of the event rate based on the patient's baseline cardiovascular risk.

beplay体育安全吗DrugBank数据引用了这篇文章

药物

双氯芬酸