Use of non-steroidal anti-inflammatory drugs and risk of ischemic and hemorrhagic stroke in the Australian veteran community

Arduino Aleksander Mangoni, Richard J. Woodman, Andrew L. Gilbert, Kathleen M. Knights

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose
Studies on the risk of stroke in users of non-steroidal anti-inflammatory drugs (NSAIDs) have provided conflicting results. We studied the association between the use of non-selective ns-NSAIDs, selective COX-2 inhibitors, or either of these NSAIDs, and the incidence of stroke-related hospitalization in elderly subjects.
Methods
We conducted a retrospective nested case-control study on Australian veterans using nationwide hospital admission and pharmacy dispensing data. Conditional logistic regression analysis was used to estimate both crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) for the risk of events for three different measures of prescription supply exposure over the last 2 years; (1) whether supplied at least once; (2) supply frequency: supplied more than twice within the last 30 days, once or twice within the last 30 days, or once or more within 30 days to 2 years; and (3) total supplies.
Results
There was a trend toward a reduced risk of ischemic stroke with any NSAID (OR 0.95, 95%CI 0.89–1.00) if supplied at least once within the last 2 years and a mildly reduced risk in those supplied any NSAID once or twice within the last 30 days (OR 0.89, 95%CI 0.81–0.98). Use of either ns-NSAIDs or selective COX-2 inhibitors were not associated with a significant change in risk.
Conclusions
Original languageEnglish
Pages (from-to)490-498
Number of pages9
JournalPharmacoepidemiology and Drug Safety
Volume19
Issue number5
Early online date30 Mar 2010
DOIs
Publication statusPublished - May 2010

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Veterans
Anti-Inflammatory Agents
Stroke
Pharmaceutical Preparations
Cyclooxygenase 2 Inhibitors
Odds Ratio
Confidence Intervals
Prescriptions
Case-Control Studies
Hospitalization
Logistic Models
Regression Analysis
Incidence

Keywords

  • non steroidal anti-inflammatory drugs
  • COX-2 inhibitors
  • stroke
  • elderly

Cite this

Use of non-steroidal anti-inflammatory drugs and risk of ischemic and hemorrhagic stroke in the Australian veteran community. / Mangoni, Arduino Aleksander; Woodman, Richard J.; Gilbert, Andrew L. ; Knights, Kathleen M. .

In: Pharmacoepidemiology and Drug Safety, Vol. 19, No. 5, 05.2010, p. 490-498.

Research output: Contribution to journalArticle

Mangoni, Arduino Aleksander ; Woodman, Richard J. ; Gilbert, Andrew L. ; Knights, Kathleen M. . / Use of non-steroidal anti-inflammatory drugs and risk of ischemic and hemorrhagic stroke in the Australian veteran community. In: Pharmacoepidemiology and Drug Safety. 2010 ; Vol. 19, No. 5. pp. 490-498.
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abstract = "Purpose Studies on the risk of stroke in users of non-steroidal anti-inflammatory drugs (NSAIDs) have provided conflicting results. We studied the association between the use of non-selective ns-NSAIDs, selective COX-2 inhibitors, or either of these NSAIDs, and the incidence of stroke-related hospitalization in elderly subjects. Methods We conducted a retrospective nested case-control study on Australian veterans using nationwide hospital admission and pharmacy dispensing data. Conditional logistic regression analysis was used to estimate both crude and adjusted odds ratios (OR) and 95{\%} confidence intervals (CI) for the risk of events for three different measures of prescription supply exposure over the last 2 years; (1) whether supplied at least once; (2) supply frequency: supplied more than twice within the last 30 days, once or twice within the last 30 days, or once or more within 30 days to 2 years; and (3) total supplies. Results There was a trend toward a reduced risk of ischemic stroke with any NSAID (OR 0.95, 95{\%}CI 0.89–1.00) if supplied at least once within the last 2 years and a mildly reduced risk in those supplied any NSAID once or twice within the last 30 days (OR 0.89, 95{\%}CI 0.81–0.98). Use of either ns-NSAIDs or selective COX-2 inhibitors were not associated with a significant change in risk. Conclusions",
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N2 - Purpose Studies on the risk of stroke in users of non-steroidal anti-inflammatory drugs (NSAIDs) have provided conflicting results. We studied the association between the use of non-selective ns-NSAIDs, selective COX-2 inhibitors, or either of these NSAIDs, and the incidence of stroke-related hospitalization in elderly subjects. Methods We conducted a retrospective nested case-control study on Australian veterans using nationwide hospital admission and pharmacy dispensing data. Conditional logistic regression analysis was used to estimate both crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) for the risk of events for three different measures of prescription supply exposure over the last 2 years; (1) whether supplied at least once; (2) supply frequency: supplied more than twice within the last 30 days, once or twice within the last 30 days, or once or more within 30 days to 2 years; and (3) total supplies. Results There was a trend toward a reduced risk of ischemic stroke with any NSAID (OR 0.95, 95%CI 0.89–1.00) if supplied at least once within the last 2 years and a mildly reduced risk in those supplied any NSAID once or twice within the last 30 days (OR 0.89, 95%CI 0.81–0.98). Use of either ns-NSAIDs or selective COX-2 inhibitors were not associated with a significant change in risk. Conclusions

AB - Purpose Studies on the risk of stroke in users of non-steroidal anti-inflammatory drugs (NSAIDs) have provided conflicting results. We studied the association between the use of non-selective ns-NSAIDs, selective COX-2 inhibitors, or either of these NSAIDs, and the incidence of stroke-related hospitalization in elderly subjects. Methods We conducted a retrospective nested case-control study on Australian veterans using nationwide hospital admission and pharmacy dispensing data. Conditional logistic regression analysis was used to estimate both crude and adjusted odds ratios (OR) and 95% confidence intervals (CI) for the risk of events for three different measures of prescription supply exposure over the last 2 years; (1) whether supplied at least once; (2) supply frequency: supplied more than twice within the last 30 days, once or twice within the last 30 days, or once or more within 30 days to 2 years; and (3) total supplies. Results There was a trend toward a reduced risk of ischemic stroke with any NSAID (OR 0.95, 95%CI 0.89–1.00) if supplied at least once within the last 2 years and a mildly reduced risk in those supplied any NSAID once or twice within the last 30 days (OR 0.89, 95%CI 0.81–0.98). Use of either ns-NSAIDs or selective COX-2 inhibitors were not associated with a significant change in risk. Conclusions

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