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Cyclooxygenase Selectivity of Nonsteroidal Anti-inflammatory Drugs and Risk of Stroke

Cyclooxygenase Selectivity of Nonsteroidal Anti-inflammatory Drugs and Risk of Stroke ORIGINAL INVESTIGATION Cyclooxygenase Selectivity of Nonsteroidal Anti-inflammatory Drugs and Risk of Stroke Mendel D. M. Haag, PharmD; Michiel J. Bos, MD; Albert Hofman, MD, PhD; Peter J. Koudstaal, MD, PhD; Monique M. B. Breteler, MD, PhD; Bruno H. C. Stricker, MB, PhD Background: In clinical trials, cyclooxygenase (COX)- unspecified). Current users of nonselective (HR, 1.72; 95% 2–selective nonsteroidal anti-inflammatory drugs confidence interval [CI], 1.22-2.44) and COX-2–selective (NSAIDs) were associated with an increased risk of throm- (HR, 2.75; 95% CI, 1.28-5.95) NSAIDs had a greater risk boembolic events. We studied the association between of stroke, but not users of COX-1–selective NSAIDs (HR, NSAID use and risk of stroke in the prospective, popu- 1.10; 95% CI, 0.41-2.97). Hazard ratios (95% CIs) for is- lation-based Rotterdam Study. chemic stroke were 1.68 (1.05-2.69) for nonselective and 4.54 (2.06-9.98) for COX-2–selective NSAIDs. For indi- Methods: We followed 7636 persons free of stroke at vidual NSAIDs, current use of the nonselective naproxen baseline (1991-1993) for incident stroke until Septem- (HR, 2.63; 95% CI, 1.47-4.72) and the COX-2–selective ro- ber 2004. Data on all filled prescriptions came from phar- fecoxib (HR, 3.38; 95% CI, 1.48-7.74) was associated with macy records. With Cox regression models, we calcu- http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Cyclooxygenase Selectivity of Nonsteroidal Anti-inflammatory Drugs and Risk of Stroke

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Publisher
American Medical Association
Copyright
Copyright 2008 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinte.168.11.1219
pmid
18541831
Publisher site
See Article on Publisher Site

Abstract

ORIGINAL INVESTIGATION Cyclooxygenase Selectivity of Nonsteroidal Anti-inflammatory Drugs and Risk of Stroke Mendel D. M. Haag, PharmD; Michiel J. Bos, MD; Albert Hofman, MD, PhD; Peter J. Koudstaal, MD, PhD; Monique M. B. Breteler, MD, PhD; Bruno H. C. Stricker, MB, PhD Background: In clinical trials, cyclooxygenase (COX)- unspecified). Current users of nonselective (HR, 1.72; 95% 2–selective nonsteroidal anti-inflammatory drugs confidence interval [CI], 1.22-2.44) and COX-2–selective (NSAIDs) were associated with an increased risk of throm- (HR, 2.75; 95% CI, 1.28-5.95) NSAIDs had a greater risk boembolic events. We studied the association between of stroke, but not users of COX-1–selective NSAIDs (HR, NSAID use and risk of stroke in the prospective, popu- 1.10; 95% CI, 0.41-2.97). Hazard ratios (95% CIs) for is- lation-based Rotterdam Study. chemic stroke were 1.68 (1.05-2.69) for nonselective and 4.54 (2.06-9.98) for COX-2–selective NSAIDs. For indi- Methods: We followed 7636 persons free of stroke at vidual NSAIDs, current use of the nonselective naproxen baseline (1991-1993) for incident stroke until Septem- (HR, 2.63; 95% CI, 1.47-4.72) and the COX-2–selective ro- ber 2004. Data on all filled prescriptions came from phar- fecoxib (HR, 3.38; 95% CI, 1.48-7.74) was associated with macy records. With Cox regression models, we calcu-

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Jun 9, 2008

References