| Author, Year Data Source Sample size | Mean age Country | Rate of Aspirin use | Main Findings |
|---|---|---|---|
| Andersohn 2006132 Nested case-control Cases=3,643 | 69 UK | NR | Acute MI, death from acute MI, or sudden death from CHD Current NSAID use vs. nonuse of NSAIDs: RR (95% CI) Celecoxib: 1.6 (1.2 to 2.0) Diclofenac: 1.4 (1.2 to 1.6) Ibuprofen: 1.0 (0.86 to 1.2) Naproxen: 1.2 (0.84 to 1.6) Other nonselective NSAIDs: 1.1 (0.98 to 1.2) |
| Cunnington, 2008148 Cohort n=71, 026 | <65 years old: 52% USA | NR | MI or ischemic stroke Chronic NSAID use vs. nonchronic or nonuse: HR (95% CI) Celecoxib: 1.0 (0.91 to 1.2) Naproxen: 0.99 (0.64 to 1.5) |
| Fischer, 2005133 Nested case-control Cases=8,688 | NR UK (GPRD) | NR | Acute MI Current NSAID use vs. nonuse of NSAIDs: OR (95% CI) Diclofenac: 1.2 (1.0 to 1.5) Ibuprofen: 1.2 (0.92 to 1.5) Naproxen: 0.96 (0.66 to 1.4) Indomethacin: 1.4 (0.82 to 2.2) Piroxicam: 0.95 (0.53 to 1.7) Ketoprofen: 0.86 (0.44 to 1.7) Fenbufen: 3.1 (1.2 to 8.1) Nabumetone: 0.62 (0.25 to 1.5) Mefenamic acid: 2.3 (0.79 to 6.7) Etodolac: 1.1 (0.40 to 3.2) Tiaprofenic acid: 0.65 (0.17 to 2.5) |
| Fosbol, 2009149 Cohort n=1,028,437 | 43 (median) Denmark | NR | MI or death NSAID use vs. nonuse of NSAIDs: HR (95% CI) Celecoxib: 1.5 (0.99 to 2.2) Diclofenac: 1.6 (1.3 to 1.9) Ibuprofen: 0.88 (0.74 to 1.1) Naproxen: 0.85 (0.49 to 1.5) |
| Garcia Rodriguez, 2004134 Nested case-control Cases: 4,975 | NR UK (GPRD) | NR | MI NSAID use vs. nonuse of NSAIDs: OR (95% CI) Naproxen: 0.89 (0.64 to 1.2) Ibuprofen: 1.1 (0.87 to 1.3.) Diclofenac: 1.2 (0.99 to 1.4) Ketoprofen: 1.1 (0.59 to 2.0) Meloxicam: 0.97 (0.60 to 1.6) Piroxicam: 1.2 (0.69 to 2.2) Indomethacin: 0.86 (0.56 to 1.3) |
| Graham 2005135 Nested case- control Cases=8,143 | NR: 18– 84 USA | Telephone interview subgroup (n=817): 23% | Acute MI requiring admission or sudden cardiac death Current NSAID use vs. remote use: OR (95% CI) Celecoxib: 0.84 (0.67 to 1.0) Ibuprofen: 1.1 (0.96 to 1.2) Naproxen: 1.1 (1.0 to 1.3) Current NSAID use vs. celecoxib use: OR (95% CI) Ibuprofen: 1.3 (1.0 to 1.6) Naproxen: 1.4 (1.1 to 1.8) |
| Helin- Salmivaara, 2006129 Case-control Cases=33,309 | NR Finland | NR | First time MI Current NSAID use vs. nonuse of NSAIDs: OR (95% CI) Indomethacin: 1.6 (1.2 to 2.0) Ibuprofen: 1.4 (1.3 to 1.6) Diclofenac: 1.4 (1.2 to 1.5) Naproxen: 1.2 (1.0 to 1.4) Piroxicam: 1.4 (0.92 to 2.0) Ketoprofen: 1.1 (0.94 to 1.3) Tolfenamic acid: 1.4 (0.90 to 2.2) Nimesulide: 1.7 (1.4 to 2.0) Etodolac: 1.4 (0.44 to 4.2) Nabumetone: 1.3 (0.59 to 2.7) Meloxicam: 1.2 (0.99 to 1.6) Celecoxib: 1.1 (0.83 to 1.3) Recent (within 30 days) NSAID use vs. nonuse of NSAIDs: OR (95% CI) Indomethacin: 1.5 (1.0 to 2.1) Ibuprofen: 1.1 (0.94 to 1.3) Diclofenac: 0.93 (0.77 to 1.1) Naproxen: 1.3 (1.0 to 1.7) Piroxicam: 0.89 (0.49 to 1.6) Ketoprofen: 1.3 (1.0 to 1.7) Tolfenamic acid: 1.3 (0.74 to 2.3) Nimesulide: 1.1 (0.91 to 1.4) Etodolac: 0.95 (0.23 to 4.0) Nabumetone: 3.0 (0.96 to 9.4) Meloxicam: 1.0 (0.77 to 1.4) Celecoxib: 0.95 (0.65 to 1.4) |
| Hippisley-Cox 2005136 Nested case- control Cases: 9,218 | NR; aged 25–100 UK | NR | First ever MI NSAID use within 3 months vs. no prescription for 3 years: OR (95% CI) Celecoxib: 1.2 (0.96 to 1.5) Ibuprofen: 1.2 (1.1 to 1.4) Diclofenac: 1.6 (1.4 to 1.7) Naproxen: 1.3 (1.0 to 1.6) Other nonselective NSAIDs: 1.2 (1.0 to 1.4) |
| Johnsen 2005137 Case-control Cases=10,280 | 70 Denmark | 7% high-dose | Acute MI Current NSAID use vs. nonuse of NSAIDs: RR (95% CI) Celecoxib: 1.2 (0.97 to 1.6) Naproxen: 1.5 (0.99 to 2.3) Other nonaspirin NSAID: 1.7 (1.5 to 1.8) New NSAID use vs. nonuse of NSAIDs: (95% CI) Celecoxib: 2.1 (1.4 to 3.1) Naproxen: 1.6 (0.57 to 4.8) Other nonaspirin NSAID: 2.6 (2.0 to 3.5) |
| Kimmel 2005138 Case-control Cases: 1,718 | NR; aged 40 to 75 USA | 34% | Nonfatal MI NSAID use vs. nonuse of NSAIDs: OR (95% CI) Celecoxib: 0.43 (0.23 to 0.79) Nonselective NSAID: 0.61 (0.52 to 0.71) |
| Levesque 2005139 Nested case- control Cases: 2,844 | NR; ≥ 66 Canada | 22% | Acute MI, fatal or nonfatal NSAID current use vs. nonuse of NSAIDs: RR (95% CI) Celecoxib: 0.99 (0.85 to 1.2) Naproxen: 1.2 (0.75 to 1.8) Meloxicam: 1.1 (0.49 to 2.3) |
| Mamdani 2003140 Cohort n=166,964 | NR; ≥ 66 Canada | 15% | Hospitalization for acute MI NSAID user vs. nonuser control: RR (95% CI) Celecoxib: 0.9 (0.7 to 1.2) Naproxen: 1.0 (0.7 to 1.7) Nonnaproxen nonselective NSAIDs: 1.2 (0.9 to 1.4) |
| Rahme, 2002141 Case-control Cases=4163 | NR (older than 65 years) Canada | NR | Hospitalization for acute MI Exposure to naproxen vs. exposure to other NSAIDs: OR 0.79 (95% CI 0.63 to 0.99) |
| Rahme, 2007130 Retrospective cohort N=283,799 | NR (>65 years) Canada | 24% | Acute myocardial infarction hospitalization Celecoxib vs. diclofenac/ibuprofen: 0.90 (0.76 to 1.1) |
| Rahme, 2007108 Retrospective cohort N=510,871 | NR; ≥ 65 Canada | 22% | Acute myocardial infarction NSAID use vs. acetaminophen use: HR (95% CI) Celecoxib: 0.97 (0.86 to 1.1) Ibuprofen: 1.0 (0.68 to 1.6) Diclofenac: 1.2 (0.96 to 1.4) Naproxen: 1.2 (0.89 to 1.5) |
| Ray 2002147 Cohort n=378,776 | 61.5 USA | NR | Serious CHD (hospital admission for acute MI or death from CHD) Current NSAID use vs. nonuse of NSAIDs: RR (95% CI) Celecoxib: 0.96 (0.76 to 1.2) Naproxen: 0.93 (0.82 to 1.1) Ibuprofen: 0.91 (0.78 to 1.1) New NSAID use vs. nonuse of NSAIDs: RR (95% CI) Celecoxib: 0.88 (0.67 to 1.2) Naproxen: 0.92 (0.73 to 1.2) Ibuprofen: 1.0 (0.77 to 1.3) |
| Schlienger, 2002143 Nested case- control Cases=3,319 | NR UK (GPRD) | NR | First acute MI NSAID use vs. nonuse of NSAIDs: OR (95% CI) Ibuprofen: 1.2 (0.87 to 1.6) Diclofenac: 1.4 (1.1 to 1.8) Piroxicam: 1.6 (0.78 to 3.5) Fenbufen: 2.1 (0.80 to 5.3) Ketoprofen: 1.4 (0.77 to 2.5) Indomethacin: 1.0 (0.58 to 1.8) Flurbiprofen: 2.3 (0.93 to 5.5) Naproxen: 0.68 (0.42 to 1.1) |
| Solomon, 2002144 Case to control Cases=4,425 | NR USA | NR | Hospitalization for MI NSAID use vs. nonuse of NSAIDs: RR (95% CI) Naproxen: 0.84 (0.72 to 0.98) Ibuprofen: 1.0 (0.88 to 1.2) NSAID use vs. ibuprofen use: RR (95% CI) Naproxen: 0.82 (0.67 to 1.0) |
| Solomon 2004145 Case-control Cases=10,895 | NR; > 80 USA | NR | Acute MI Celecoxib use vs. no celecoxib use: OR 0.93 (95% CI 0.84 to 1.0) Celecoxib use vs. naproxen use: OR 0.95 (95% CI 0.74 to 1.2) Celecoxib use vs. ibuprofen use: OR 0.98 (95% CI 0.76 to 1.3) Celecoxib use vs. other NSAID use: OR 0.95 (95% CI 0.82 to 1.1) |
| Solomon, 2008131 Cohort n=175,654 | 80 years USA | NR | MI, stroke, CHF, and out-of-hospital death attributable to cardiovascular disease NSAID use vs. nonuse of NSAIDs: HR (95% CI) Celecoxib: 0.89 (0.83 to 0.94) Diclofenac: 1.2 (1.1 to 1.3) Ibuprofen: 0.96 (0.83 to 1.1) Naproxen: 0.79 (0.67 to 0.93) Other nonselective NSAIDs: 0.87 (0.79 to 0.96) |
| Velentgas 2006146 Cohort n=424,584 | NR (40–64 years) USA | NR | Acute coronary syndrome or MI Current NSAID use vs. current ibuprofen use: RR (95% CI) Celecoxib: 1.0 (0.83 to 1.3) Naproxen: 1.1 (0.93 to 1.4) |
CHD = coronary heart disease; CHF = congestive heart failure; HR = hazard ratio; MI = myocardial infarction; NR = not reported; NSAID = nonsteroidal anti-inflammatory drug; OR = odds ratio; RR = relative risk; UK GPRD = United Kingdom General Practice Research Database
From: Results
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