nsaid use selectively increases the risk of non-fatal myocardial infarction a systematic review of randomised trials and observational studies非甾体抗炎药使用选择性地增加非致命性心肌梗塞的风险系统回顾的随机试验和观察性研究.pdfVIP

NSAID Use Selectively Increases the Risk of Non-Fatal Myocardial Infarction: A Systematic Review of Randomised Trials and Observational Studies ´ ´ 1 ´ ´ 1,2 ´ 3 4 Luis Alberto Garcıa Rodrıguez *, Antonio Gonzalez-Perez , Hector Bueno , John Hwa ˜ ´ ´ ´ 1 Centro Espanol de Investigacion Farmacoepidemiologica (CEIFE), Madrid, Spain, 2 Departamento de Genomica Estructural, Neocodex SL, Sevilla, Spain, 3 Department of ˜ ´ Cardiology, Hospital General Universitario Gregorio Maranon, Madrid, Spain, 4 Section of Cardiovascular Medicine, Department of Medicine, Yale University School of Medicine, New Haven, Connecticut, United States of America Abstract Background: Recent clinical trials and observational studies have reported increased coronary events associated with non steroidal anti-inflammatory drugs (NSAIDs). There appeared to be a disproportionate increase in non-fatal versus fatal events, however, numbers of fatal events in individual studies were too small, and event rates too low, to be meaningful. Objectives: We undertook a pooled analysis to investigate the effect of NSAIDs on myocardial infarction (MI) risk with the specific aim to differentiate non-fatal from fatal events. Methods: We searched Pubmed (January, 1990 to March, 2010) for observational studies and randomised controlled trials that assessed the effect of NSAIDs (traditional or selective COX-2 inhibitors [coxibs]) on MI incidence separately for fatal and non-fatal events.