1. Coronary Events After Dispensing of Ibuprofen: A Propensity Score-Matched Cohort Study Versus Paracetamol in the French Nationwide Claims Database Sample.
- Author
-
Duong M, Abouelfath A, Lassalle R, Droz C, Blin P, and Moore N
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Comorbidity, Databases, Factual, Dose-Response Relationship, Drug, Drug Therapy, Combination, Female, France, Humans, Male, Middle Aged, Propensity Score, Young Adult, Acetaminophen adverse effects, Acute Coronary Syndrome chemically induced, Anti-Inflammatory Agents, Non-Steroidal adverse effects, Aspirin adverse effects, Ibuprofen adverse effects
- Abstract
Introduction: Non-steroidal anti-inflammatory drugs are associated with a dose and duration-dependent coronary risk. There is little information concerning analgesic-dose ibuprofen, among the most widely used drugs worldwide., Objective: Our objective was to measure the risks of acute coronary syndrome (ACS) after dispensing of ibuprofen, versus paracetamol., Methods: Propensity score 1:2-matched cohorts of ibuprofen or paracetamol treatment episodes (TEs) in Echantillon Généraliste de Bénéficiaires (EGB), the 1/97 sample of Système National des Données de Santé (SNDS), the French nationwide claims database, from 2009 to 2014, were compared. Outcomes were hospital admissions for ACS during the 3 months after the dispensing of ibuprofen or paracetamol. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated overall and stratified on low-dose aspirin dispensing., Results: A total of 315,269 ibuprofen TEs in 168,400 persons were matched to 630,457 paracetamol TEs in 395,952 patients. Event rates were 50-100 times higher in low-dose aspirin users (27 vs 0.28 per 1000 patient years). Overall there was no difference in risk of ACS at 3 months (HR 0.94, 95% CI 0.74-1.20) despite a transient increase in the first 2 weeks in ibuprofen users (HR 1.70, 95% CI 1.11-2.59). In the stratified analysis, this short-term risk was only found in aspirin users (5% of population, HR 1.84, 95% CI 1.24-3.24), but not in non-aspirin users (HR 1.09, 95% CI 0.40-2.94)., Conclusions: There was no evidence for an increased risk of ACS in patients dispensed ibuprofen compared to paracetamol.
- Published
- 2018
- Full Text
- View/download PDF