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Editor's Correspondence |

Risk of Myocardial Infarction Associated With Selective COX-2 Inhibitors: Questions Remain

Peter Jüni, MD; Paul Dieppe, MD; Matthias Egger, MD
Arch Intern Med. 2002;162(22):2639. doi:.
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The 3 case-control studies by Drs Rahme, Solomon, Watson, and their colleagues13 published recently in the ARCHIVES suggest that the main reason for an increased risk of MI found for rofecoxib when compared with naproxen in the Vioxx Gastrointestinal Outcomes Research (VIGOR) trial4 may be a cardioprotective effect of naproxen. We have 2 concerns with this interpretation.

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Random effects meta-analysis of 3 case-control studies published in the ARCHIVES on the association between naproxen use and protection against myocardial infarction (MI). Data are estimates with 95% confidence intervals. Odds ratios are shown for case-control studies and a risk ratio is shown for the Vioxx Gastrointestinal Outcomes Research (VIGOR) trial. An estimate below 1 indicates that naproxen use is associated with a decreased risk of MI. The size of the squares is proportional to the inverse of variance of estimates; the diamond indicates the pooled estimate.

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Correspondence

December 9, 2002
Elham Rahme, PhD; Louise Pilote, MD, mph, phd; Jacques LeLorier, MD, phd, FRCPC
Arch Intern Med. 2002;162(22):2641. doi:.
December 9, 2002
Douglas J. Watson, PhD; Thomas Rhodes, MS; Bing Cai, MS; Harry A. Guess, MD, PhD
Arch Intern Med. 2002;162(22):2642. doi:.
December 9, 2002
Daniel Solomon, MD, MPH; Jerry Avorn, MD; Robert J. Glynn, PhD, ScD
Arch Intern Med. 2002;162(22):2640. doi:.
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