Relationship between selective cyclooxygenase-2 inhibitors and acute myocardial infarction in older adults

Abstract

Background-Although cyclooxygenase-2 inhibitors (coxibs) were developed to cause less gastrointestinal hemorrhage than nonselective nonsteroidal antiinflammatory drugs (NSAIDs), there has been concern about their cardiovascular safety. We studied the relative risk of acute myocardial infarction (AMI) among users of celecoxib, rofecoxib, and NSAIDs in Medicare beneficiaries with a comprehensive drug benefit. Celecoxib was not associated with an increased relative risk of AMI in these comparisons. Conclusions-In this study, current rofecoxib use was associated with an elevated relative risk of AMI compared with celecoxib use and no NSAID use. Dosages of rofecoxib Ͼ25 mg were associated with a higher risk than dosages Յ25 mg. The risk was elevated in the first 90 days of use but not thereafter.