Helin-Salmivaara Arja, Virtanen Arja, Vesalainen Risto, Grönroos Juha M, Klaukka Timo, Idänpään-Heikkilä Juhana E, Huupponen Risto
Centre for Pharmacotherapy Development and Postgraduate School of Clinical Drug Research, University of Turku, PB 55, FIN-00301 Helsinki, Finland.
Eur Heart J. 2006 Jul;27(14):1657-63. doi: 10.1093/eurheartj/ehl053. Epub 2006 May 26.
To evaluate the risk of first myocardial infarction (MI) associated with the use of various non-steroidal anti-inflammatory drugs (NSAIDs) in the general population.
We conducted a population-based matched case-control study over the years 2000-3 in outpatient residents of Finland. In the nationwide Hospital Discharge Register 33 309 persons with first time MI were identified. A total of 138 949 controls individually matched for age, gender, hospital catchment area, and index day were selected from the Population Register. For combined NSAIDs, the adjusted odds ratio for the risk of first MI with current use was 1.40 (95% CI, 1.33-1.48). The risk was similar for conventional (1.34; 1.26-1.43), semi-selective (etodolac, nabumetone, nimesulide, and meloxicam) (1.50; 1.32-1.71), and cyclo-oxygenase-2 (COX-2) selective NSAIDs (rofecoxib, celecoxib, valdecoxib, and etoricoxib) (1.31; 1.13-1.50). Age of current user did not consistently modify the risk. No NSAID was associated with an MI-protective effect. All durations from 1 to 180 days of conventional NSAIDs and from 31 to 90 days duration of COX-2 selective NSAIDs were associated with an elevated risk of MI.
Current use of all NSAIDs is associated with a modest risk of first time MI.
评估普通人群中使用各种非甾体抗炎药（NSAIDs）与首次心肌梗死（MI）的风险。
我们在2000年至2003年期间对芬兰门诊居民进行了一项基于人群的匹配病例对照研究。在全国医院出院登记册中，识别出33309例首次发生心肌梗死的患者。从人口登记册中选取了138949名对照，这些对照在年龄、性别、医院服务区域和索引日方面进行了个体匹配。对于联合使用的NSAIDs，当前使用时首次心肌梗死风险的调整后优势比为1.40（95%置信区间，1.33 - 1.48）。传统NSAIDs（1.34；1.26 - 1.43）、半选择性NSAIDs（依托度酸、萘丁美酮、尼美舒利和美洛昔康）（1.50；1.32 - 1.71）以及环氧化酶 - 2（COX - 2）选择性NSAIDs（罗非昔布、塞来昔布、伐地昔布和艾瑞昔布）（1.31；1.13 - 1.50）的风险相似。当前使用者的年龄并未持续改变风险。没有NSAID具有心肌梗死保护作用。传统NSAIDs使用1至180天以及COX - 2选择性NSAIDs使用31至90天的所有时间段都与心肌梗死风险升高相关。
当前使用所有NSAIDs均与首次心肌梗死的适度风险相关。
