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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

2008; SAGE Publishing; Volume: 13; Issue: 4 Linguagem: Inglês

10.1177/1074248408323136

1940-4034

John J. Warner, Rick Weideman, Kevin C. Kelly, Emmanouil S. Brilakis, Subhash Banerjee, Francesca Cunningham, William V. Harford, Salahuddin Kazi, Bertis B. Little, Byron Cryer,

Synthesis of β-Lactam Compounds

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.