The Tell-Tale Heart: Population-Based Surveillance Reveals an Association of Rofecoxib and Celecoxib with Myocardial Infarction
2007

COX-2 Inhibitors and Myocardial Infarction Risk

Sample size: 25486 publication Evidence: high

Author Information

Author(s): John S. Brownstein, Margarita Sordo, Isaac S. Kohane, Kenneth D. Mandl

Primary Institution: Children's Hospital Informatics Program at the Harvard-MIT Division of Health Sciences and Technology

Hypothesis

Does population health monitoring reveal the effect of COX-2 inhibitors on myocardial infarction rates?

Conclusion

The study found a strong relationship between the use of COX-2 inhibitors and an increase in myocardial infarction rates.

Supporting Evidence

  • There was a 18.5% increase in inpatient stays for myocardial infarction when both rofecoxib and celecoxib were on the market.
  • For every million prescriptions of rofecoxib and celecoxib, there was a 0.5% increase in myocardial infarction.
  • The mean age at myocardial infarction decreased with increased prescriptions of COX-2 inhibitors.

Takeaway

This study shows that taking certain pain medications can lead to more heart attacks in people.

Methodology

A retrospective study analyzing inpatient data from two Boston hospitals between January 1997 and March 2006.

Potential Biases

Potential geographic variation in prescription practices may affect results.

Limitations

The study only included inpatients, which may underestimate overall myocardial infarction rates.

Participant Demographics

Patients hospitalized for myocardial infarction in Boston, Massachusetts.

Statistical Information

P-Value

<0.001

Confidence Interval

95%CI 0.1 to 0.9

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1371/journal.pone.0000840

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