Increased myocardial infarction risk a class effect of NSAIDs

The cardiovascular safety of COX-2 inhibitors and non-selective NSAIDs were the subject of several presentations at this year's annual meeting of the European League Against Rheumatism (EULAR) [Vienna, Austria; June 2005]. An analysis of data from the California Medicaid database indicated that non-selective NSAIDs are associated with an increased risk of acute myocardial infarction (AMI), which is in some cases greater than that of COX-2 inhibitors. This study also demonstrated that rofecoxib [Vioxx] is associated with a higher incidence of such events than celecoxib [Celebrex] and valdecoxib [Bextra], and that the risk of AMI increased with higher doses; this latter is particularly worrying as a study has shown that the average doses of COX-2 inhibitors prescribed in the US have risen since 1999. Non-selective NSAIDs were shown to be associated with an increased risk of AMI in a late-breaking study also presented at the EULAR meeting, which also suggested that the risk was increased in patients receiving concomitant aspirin therapy.