Characteristics of included studies

Studies

Design

Data source

NSAID exposure

Study outcome

AMI events (n)

No AMI events (n)

[ Study 1]

Nested case control GPRD (UK)

Current NSAID users:

First hospitalized

Diclofenac = 213

Diclofenac = 679

MI risk factors (smoking,

patients (age 50–84

AMI or death due to

Ibuprofen = 155

Ibuprofen = 575

diabetes, hypertension,

years) whose most

CHD

Naproxen = 49

Naproxen = 206

hyperlipidemia, BMI, RA,

recent prescription

OA, anemia, CHD, CVD),

lasted until the index

age, sex, calendar year,

date or ended in the 30

alcohol intake, and use of

days before the index

steroids, aspirin,

date

anticoagulants, paracetamol, and NSAIDs

[ Study 2]

Nested case control GPRD (UK)

Current NSAID users:

First hospitalized

Nonaspirin NSAIDs

Nonaspirin NSAIDs

Age, use of HRT, smoking,

menopausal women

AMI

= 40

= 143

hypertension, diabetes,

(age 50–74 years) who

obesity, surgical

had a prescription for

menopause, family history

NSAIDs before the index

of CHD, and predefined

date

co-morbidity

[ Study 3]

Nested case control Managed care

Current NSAID users:

Hospitalized AMI,

Ibuprofen = 670

Ibuprofen = 2573

Sex, age, geographic

database (USA)

patients (age 18–84 years) who had ≥1

sudden cardiac death

Naproxen = 367

Naproxen = 1409

location, cardiovascular risk score, admission for

prescription for a COX 2

noncardiac-related

selective or non-

disorders and same-day

selective NSAID

procedures, emergency room visits for

noncardiovascular reasons,

HRT, and high-dose prednisolone

[ Study 4]

Nested case control QRESEARCH

Current NSAID users:

First hospitalized

Ibuprofen = 460

Ibuprofen = 3199

Use of aspirin, statin,

(UK)

patients (age 25–100

AMI/CHD, sudden

Naproxen = 96

Naproxen = 677

tricyclic antidepressants,

years) who had a

death

Other nonselective

Other nonselective

SSRI, ischemic heart

prescription for selective

NSAIDs = 181

NSAIDs = 1266

disease, diabetes,

or nonselective NSAIDs

hypertension, OA, RA,

within the 3 months

smoking obesity, and

before the index data

deprivation

[ Study 5]

Case control Hospital discharge

Current nonaspirin

First hospitalized

Naproxen = 26

Naproxen = 175

Discharge diagnosis of

registry (Denmark)

NSAID users: patients

AMI

Other nonaspirin

Other nonaspirin

CVD, hypertension,

(age 20–101 years) who

NSAIDs = 532

NSAIDs = 3105

diabetes, chronic bronchitis

had received a

or emphysema, acholoism,

prescription within 30

liver cirrhosis, upper GI

days before the index

bleed, RA, systemic lupus

date

erythematosus and use of high-dose aspirin, platelet inhibitors, insulin or oral

hypoglycemic drugs, antihypertensive drugs, lipid-lowering drugs, oral anticoagulants, hormone therapy, nitrates, penicillamine, gold and glucocorticocoids before date of admission

[ Study 6]

Nested case control Administrative health database

New NSAID users: patients (age ≥66 years)

First Hospitalized AMI

Naproxen = 23 Other nonselective,

Naproxen = 336 Other nonselective,

Age, sex, hypertension, CAD, cerebrovascular

(Québec, Canada)

who had a dispensed

nonaspirin NSAIDs

nonaspirin NSAIDs

disease, peripheral

prescription with a

= 51

= 962

vascular disease, CCF,

duration that covered or

statin, aspirin,

overlapped with the

anticoagulants, presence of

index date

respiratory disease, GI ulcer disease, thyroid disease, depression or psychiatric illness, use of oral corticosteroids,

Chronic disease score,

Charlson index, health care

utilization

[ Study 7]

Retrospective cohort Administrative health database

New NSAID users: patients (age ≥66 years)

Hospitalized AMI

Naproxen = 15 Other nonselective,

Naproxen = 5654 Other nonselective,

Hospitalization in prior year, malignancy in prior 5 years,

(Ontario, Canada)

who received a

non-naproxen

nonaspirin NSAIDs

MI, stroke, CAD or CABG