RT Journal
A1 Fischer LM, Schlienger RG, Matter CM, Jick H, Meier CR
T1 DIscontinuation of nonsteroidal anti-inflammatory drug therapy and risk of acute myocardial infarction
JF Archives of Internal Medicine
JO Archives of Internal Medicine
YR 2004
FD December 13
VO 164
IS 22
SP 2472
OP 2476
DO 10.1001/archinte.164.22.2472
UL http://dx.doi.org/10.1001/archinte.164.22.2472
AB Background 
    Systemic inflammation has been shown to be associated with an increased risk of acute myocardial infarction (AMI). However, the effect of the use of nonsteroidal anti-inflammatory drugs (NSAIDs) on the risk of AMI has not yet been well defined. We therefore studied the risk of AMI during NSAID exposure and after the cessation of NSAID therapy.Methods 
    We conducted a large case-control analysis on the British General Practice Research Database. The study included 8688 cases with a first-time AMI between 1995 and 2001 and 33 923 controls, matched to cases on age, sex, calendar time, and general practice attended.Results 
    After adjusting for hypertension, hyperlipidemia, diabetes mellitus, ischemic heart disease, rheumatoid arthritis, systemic lupus erythematosus, acute chest infection, body mass index, smoking, and aspirin use, the risk of AMI was 1.52 (95% confidence interval [CI], 1.33-1.74) for subjects who stopped taking NSAIDs 1 to 29 days prior to the index date, compared with nonusers. The risk was highest in subjects with rheumatoid arthritis or systemic lupus erythematosus (adjusted OR, 3.68 [95% CI, 2.36-5.74]) and for subjects who discontinued therapy with NSAIDs after previous long-term use (adjusted OR, 2.60 [95% CI, 1.84-3.68]). Current and past NSAID use (discontinued therapy ≥60 days prior to the index date) were not associated with an increased risk of AMI (adjusted OR, 1.07 [95% CI, 0.96-1.19] and 1.05 [95% CI, 0.99-1.12], respectively).Conclusion 
    Our findings suggest that the risk of AMI is increased during several weeks after the cessation of NSAID therapy.