Role of Dose Potency in the Prediction of Risk of Myocardial Infarction Associated With Nonsteroidal Anti-Inflammatory Drugs in the General Population
Luis Alberto García Rodríguez, MD*,*,
Stefania Tacconelli, PhD and
Paola Patrignani, PhD
* Centro Español de Investigación Farmacoepidemiológica (CEIFE), Madrid, Spain
Department of Medicine and Center of Excellence on Aging, G. d'Annunzio University, School of Medicine, CeSI, Chieti, Italy
View larger version (46K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 1 Degree of Inhibition of COX-2 by Average Circulating Concentrations of Individual NSAIDs Functionally Selective for COX-2 Is Relevant to RR of Nonfatal MI
(A) Relative risk (RR) and 95% confidence interval (CI) of MI according to use of individual nonsteroidal anti-inflammatory drugs (NSAIDs). (B) Effects of therapeutic concentrations of NSAIDs on whole blood COX-1 (blue bars), mostly from platelets, and COX-2 (green bars), mostly from monocytes, in vitro. The dotted line represents the functional range of inhibition of platelet COX-1, namely,  95% (9). (C) Relationship between degree of inhibition of whole blood COX-2 and RR of MI by individual NSAIDs. Naproxen, which affects platelet COX-1 activity at functional range, is not shown. The linear regression analysis yielded a significant correlation between the 2 variables. It was performed using InStat (GraphPad, San Diego, California). Cele = celecoxib; Diclo = diclofenac; Etod = etodolac; Etori = etoricoxib; Ibu = ibuprofen; Indo = indomethacin; Melo = meloxicam; Piro = piroxicam; Rofe = rofecoxib.
|
|
View larger version (13K):
[in this window]
[in a new window]
[Download PPT slide]
|
Figure 2 Effect of Daily Dose and Formulation of Diclofenac on RR of Nonfatal MI
Effect of the daily dose and formulation (slow release compared with plain) of diclofenac on relative risk (RR) of nonfatal myocardial infarction (MI) is shown. The RR and 95% confidence interval of MI according to daily dose of diclofenac are compared with nonuse and stratified by presentation form.
|
|
|
