TY - JOUR
T1 - Stroke risk and NSAIDs
T2 - an Australian population-based study
AU - Caughey, Gillian E.
AU - Roughead, Elizabeth E.
AU - Pratt, Nicole
AU - Killer, Graeme
AU - Gilbert, Andrew L.
PY - 2011/11
Y1 - 2011/11
N2 - Objective: To determine the risk of stroke associated with non-steroidal I anti-inflammatory drug (NSAID) use.Design, setting and participants: Retrospective cohort study of 162 065 I Australian veterans with incident dispensing of an NSAID between 1 January 2001 and 31 December 2008, using prescription event sequence symmetry analysis.Main outcome measures: Hospitalisation for stroke, ischaemic stroke or haemorrhagic stroke.Results: The absolute risk of stroke was low: 7.1/1000 people/year. Incident use I of NSAIDs was associated with a 1.88 times increased risk (95% CI, 1.70-2.08) of hospitalisation for stroke (ischaemic or haemorrhagic) following first ever dispensing of an NSAID. This equates to an increased absolute risk of 13.4 strokes/1000 people/year. Significant positive associations between starting an NSAID and having a hospitalisation for stroke were found for most NSAIDs, with adjusted sequence ratios ranging from 1.44 (95% CI, 1.16-1.80) for indomethacin to 1.80 (95% CI, 1.59-2.04) for rofecoxib.Conclusions: Incident use of NSAIDs was associated with an increased risk of I stroke. Increased awareness of the potential for serious adverse cardiovascular events, together with individual assessment of cardiovascular risk, careful deliberation of the balance between risk and benefits and appropriate I supervision, is required when initiating NSAID therapy.
AB - Objective: To determine the risk of stroke associated with non-steroidal I anti-inflammatory drug (NSAID) use.Design, setting and participants: Retrospective cohort study of 162 065 I Australian veterans with incident dispensing of an NSAID between 1 January 2001 and 31 December 2008, using prescription event sequence symmetry analysis.Main outcome measures: Hospitalisation for stroke, ischaemic stroke or haemorrhagic stroke.Results: The absolute risk of stroke was low: 7.1/1000 people/year. Incident use I of NSAIDs was associated with a 1.88 times increased risk (95% CI, 1.70-2.08) of hospitalisation for stroke (ischaemic or haemorrhagic) following first ever dispensing of an NSAID. This equates to an increased absolute risk of 13.4 strokes/1000 people/year. Significant positive associations between starting an NSAID and having a hospitalisation for stroke were found for most NSAIDs, with adjusted sequence ratios ranging from 1.44 (95% CI, 1.16-1.80) for indomethacin to 1.80 (95% CI, 1.59-2.04) for rofecoxib.Conclusions: Incident use of NSAIDs was associated with an increased risk of I stroke. Increased awareness of the potential for serious adverse cardiovascular events, together with individual assessment of cardiovascular risk, careful deliberation of the balance between risk and benefits and appropriate I supervision, is required when initiating NSAID therapy.
UR - http://www.scopus.com/inward/record.url?scp=84855163593&partnerID=8YFLogxK
U2 - 10.5694/mja11.10055
DO - 10.5694/mja11.10055
M3 - Article
C2 - 22060087
AN - SCOPUS:84855163593
SN - 0025-729X
VL - 195
SP - 525
EP - 529
JO - Medical Journal of Australia
JF - Medical Journal of Australia
IS - 9
ER -
