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
Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, Texas 75390, USA.
J Cardiovasc Pharmacol Ther. 2008 Dec;13(4):252-60. doi: 10.1177/1074248408323136. Epub 2008 Sep 11.
This study compares the risk of acute myocardial infarction among patients exposed to etodolac, naproxen, celecoxib, and rofecoxib.
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.
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.
Etodolac is not associated with a statistically increased risk of acute myocardial infarction compared to naproxen.
本研究比较了服用依托度酸、萘普生、塞来昔布和罗非昔布的患者发生急性心肌梗死的风险。
一项针对38258名退伍军人患者（26376患者年）的回顾性队列研究，测量了服用依托度酸、萘普生、塞来昔布或罗非昔布期间急性心肌梗死的校正比值比。
100名服用研究中的非甾体抗炎药的患者被确诊为急性心肌梗死。与萘普生相比，依托度酸导致急性心肌梗死风险增加并不显著（比值比=1.32，P=0.27），而塞来昔布（比值比=2.18，95%可信区间1.09 - 4.35，P=0.03）和罗非昔布（比值比=2.16，95%可信区间1.04 - 4.46，P=0.04）导致急性心肌梗死风险增加显著。一项事后分析表明，有急性心肌梗死病史的患者若服用塞来昔布或罗非昔布，再次发生急性心肌梗死的风险显著增加4.26倍。
与萘普生相比，依托度酸与急性心肌梗死风险的统计学增加无关。
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