The risk of acute myocardial infarction with etodolac is not increased compared to naproxen: A historical cohort analysis of a generic COX-2 selective inhibitor

Abstract

Background: This study compares the risk of acute myocardial infarction among patients exposed to etodolac, naproxen, celecoxib, and rofecoxib. Methods: A retrospective cohort study in 38 258 veteran patients (26 376 patient-years) measured the adjusted odds ratios of acute myocardial infarction during exposure to etodolac, naproxen, celecoxib, or rofecoxib. Results: Diagnosis of acute myocardial infarction was confirmed in 100 patients who were exposed to a study nonsteroidal anti-inflammatory drug. Compared to naproxen, the increased risk of acute myocardial infarction was not significant for etodolac (OR = 1.32, P =.27), whereas celecoxib (OR = 2.18, 95% CI 1.09-4.35, P =.03) and rofecoxib (OR = 2.16, 95 CI 1.04-4.46, P =.04) were significant. A post hoc analysis indicates that patients with a prior history of acute myocardial infarction had a significant, 4.26-fold risk for another acute myocardial infarction if taking celecoxib or rofecoxib. Conclusion: Etodolac is not associated with a statistically increased risk of acute myocardial infarction compared to naproxen. © 2008 Sage Publications.