BMJ  2005;330:1370 (11 June), doi:10.1136/bmj.330.7504.1370

Primary care

Differences in outcomes of patients with congestive heart failure prescribed celecoxib, rofecoxib, or non-steroidal anti-inflammatory drugs: population based study

¹ Division of Clinical Epidemiology, Research Institute of McGill University Health Center, 1650 Cedar Avenue, Montreal, QC, H3G 1A4 Canada

Objectives To compare the risk of death and recurrent congestive heart failure in elderly patients prescribed celecoxib, rofecoxib, or non-steroidal anti-inflammatory drugs (NSAIDs) and to determine whether there are class differences between celecoxib and rofecoxib.

Design Population based retrospective cohort study.

Setting Databases of hospital discharge summaries and prescription drug claims in Quebec.

Participants 2256 patients aged 66 or more prescribed celecoxib, rofecoxib, or an NSAID after an index admission for congestive heart failure between April 2000 and March 2002.

Main outcome measures Time to all cause death and recurrent congestive heart failure, combined and separately.

Results The risk of death and recurrent congestive heart failure combined was higher in patients prescribed NSAIDs or rofexocib than in those prescribed celecoxib (hazard ratio 1.26, 95% confidence interval 1.00 to 1.57 and 1.27, 1.09 to 1.49, respectively). The findings were similar when the outcomes were assessed separately. In pairwise analysis, the risks of death and recurrent congestive heart failure, combined and separate, were similar between patients prescribed NSAIDs and rofecoxib.

Conclusions Celecoxib seems safer than rofecoxib and NSAIDs in elderly patients with congestive heart failure. Differences were found among cyclo-oxygenase-2 inhibitors.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Related Articles

Celecoxib seems to be the choice for congestive heart failure
BMJ 2005 330: 0. [Full Text]

COX 2 inhibitors, traditional NSAIDs, and the heart

Peter Jüni, Stephan Reichenbach, and Matthias Egger
BMJ 2005 330: 1342-1343. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Aneja, A., Farkouh, M. E. (2008). Review: Adverse cardiovascular effects of NSAIDs: driven by blood pressure, or edema?. Therapeutic Advances in Cardiovascular Disease 2: 53-66 [Abstract]  
• Zarraga, I. G. E., Schwarz, E. R. (2007). Coxibs and Heart Disease: What We Have Learned and What Else We Need to Know. J Am Coll Cardiol 49: 1-14 [Abstract] [Full text]  
• Luyten, F P, Geusens, P, Malaise, M, De Clerck, L, Westhovens, R, Raeman, F, Vander Mijnsbrugge, D, Mathy, L, Hauzeur, J P, De Keyser, F, Van den Bosch, F (2007). A prospective randomised multicentre study comparing continuous and intermittent treatment with celecoxib in patients with osteoarthritis of the knee or hip. Ann Rheum Dis 66: 99-106 [Abstract] [Full text]  
• Anning, P. B., Coles, B., Morton, J., Wang, H., Uddin, J., Morrow, J. D., Dey, S. K., Marnett, L. J., O'Donnell, V. B. (2006). Nitric oxide deficiency promotes vascular side effects of cyclooxygenase inhibitors. Blood 108: 4059-4062 [Abstract] [Full text]  
• Chaiamnuay, S., Allison, J. J., Curtis, J. R. (2006). Risks versus benefits of cyclooxygenase-2-selective nonsteroidal antiinflammatory drugs.. Am J Health Syst Pharm 63: 1837-1851 [Abstract] [Full text]  
• Gislason, G. H., Jacobsen, S., Rasmussen, J. N., Rasmussen, S., Buch, P., Friberg, J., Schramm, T. K., Abildstrom, S. Z., Kober, L., Madsen, M., Torp-Pedersen, C. (2006). Risk of Death or Reinfarction Associated With the Use of Selective Cyclooxygenase-2 Inhibitors and Nonselective Nonsteroidal Antiinflammatory Drugs After Acute Myocardial Infarction. Circulation 113: 2906-2913 [Abstract] [Full text]  
• Sooriakumaran, P (2006). COX-2 inhibitors and the heart: are all coxibs the same?. Postgrad. Med. J. 82: 242-245 [Abstract] [Full text]  
• Chan, A. T., Manson, J. E., Albert, C. M., Chae, C. U., Rexrode, K. M., Curhan, G. C., Rimm, E. B., Willett, W. C., Fuchs, C. S. (2006). Nonsteroidal Antiinflammatory Drugs, Acetaminophen, and the Risk of Cardiovascular Events. Circulation 113: 1578-1587 [Abstract] [Full text]  

Rapid Responses:

Read all Rapid Responses

Celecoxib is not a safer alternative in heart failure

Juan-Carlos Maldonado
bmj.com, 24 Jun 2005 [Full text]

Variations in frequency of concomitant prescriptions of coumarine anticoagulants and NSAIDs

Michal R. Pijak, et al.
bmj.com, 5 Jul 2005 [Full text]

Differences in the cardiovascular risk between NSAIDs and coxibs: the neglected role of pharmacokinetics and drug interactions

Michal R. Pijak, et al.
bmj.com, 6 Jul 2005 [Full text]