Myocardial Infarction and Its Association with the Use of Nonselective NSAIDs: A Nested Case-Control and Time-to-Event Analysis.

Objective: In April 2005, the US Food and Drug Administration issued a public health advisory warning to health care clinicians about the cardiovascular (CV) safety of nonsteroidal anti-inflammatory drugs (NSAIDs). Although the warning about cyclooxygenase-2 selective NSAIDs was anticipated, little data exists about the CV safety of nonselective NSAIDs. We analyzed data from a group of NSAID users to determine if specific nonselective agents were associated with an increased risk of myocardial infarctions (MIs) and sudden cardiac death (SCD).

Successful conversion of patients with hypercholesterolemia from a brand name to a generic cholesterol-lowering drug.

Objective: To evaluate the safety and effectiveness of a simvastatin-to-lovastatin therapeutic conversion program.

Study Design: Observational database study of a therapeutic conversion in members of the Northern and Southern California regions of Kaiser Permanente, using a pretest/posttest design.

Methods: All patients actively converted from simvastatin to lovastatin between April 1, 2002, and March 31, 2003, were identified for inclusion in the analysis.

Risk of acute myocardial infarction and sudden cardiac death in patients treated with cyclo-oxygenase 2 selective and non-selective non-steroidal anti-inflammatory drugs: nested case-control study.

Background: Controversy has surrounded the question about whether high-dose rofecoxib increases or naproxen decreases the risk of serious coronary heart disease. We sought to establish if risk was enhanced with rofecoxib at either high or standard doses compared with remote non-steroidal anti-inflammatory drug (NSAID) use or celecoxib use, because celecoxib was the most common alternative to rofecoxib.

Methods: We used data from Kaiser Permanente in California to assemble a cohort of all patients age 18-84 years treated with a NSAID between Jan 1, 1999, and Dec 31, 2001, within which we did a nested case-control study.

Relationship of clinical factors to the use of Cox-2 selective NSAIDs within an arthritis population in a large HMO.

Objective: To investigate the degree to which physicians use clinical factors to focus use of Cox-2 selective NSAIDs within an arthritis population.

Methods: Diagnostic codes in the medical records of a large group-model HMO in northern California with approximately 3 million members were examined to identify patients with either rheumatoid arthritis (RA) or non-RA (osteoarthritis or degenerative joint disease). RA and non-RA patients were stratified in deciles of relative risk for gastrointestinal (GI) complications according to patient characteristics identified on the Standardized Calculator of Risk for Events (SCORE) that were associated with use of Cox-2 selective NSAIDs.