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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThis study examined the ability of concomitant use of aspirin to off-set the risk of acute myocardial infarction (MI) in patients being treated with cyclooxygenase-2 (COX-2) selective and nonselective NSAIDs. Data was derived from a California (United States) Medicaid database of patients diagnosed with OA or RA.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Erheumatoid arthritis\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Earthritis clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Emyocardial infarction\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EThis study examined the ability of concomitant use of aspirin to offset the risk of acute myocardial infarction (MI) in patients being treated with cyclooxygenase-2 (COX-2) selective and non-selective NSAIDs. The protocol was based on the increased risk of MI reported with the use of these agents. The hypothesis was based on studies that suggest that inhibition of thromboxane by aspirin may reverse the imbalance resulting from selective inhibition of COX-2-mediated prostacyclin formation.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EData was derived from a California Medicaid database of patients diagnosed with OA or RA. Patients were matched as to age, gender, and length of drug exposure. From this database, 15,343 cases of acute MI (8% fatal) were identified. Adjusted risk ratios (95% CI) of acute MI were 1.31 (1.20 \u2212 1.43) with rofecoxib, 1.13 (1.04 \u2212 1.19) with celecoxib, 1.08 (0.97 \u2212 1.19) with ibuprofen, 1.65 (1.27 \u2212 2.15) with indomethacin, 1.52 (1.14 \u2212 2.03) with meloxicam, and 1.47 (1.03 \u2212 2.11) with sulindac. Concomitant use of aspirin reversed MI risk with rofecoxib to 1.03, with celecoxib to 0.88, with meloxicam to 0.53, and with sulindac to 0.77. The risk was partially reversed with indomethacin to 1.21, but unchanged with ibuprofen (1.20).\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003EThe authors concluded that COX-2 selective and NSAIDS contribute to an increased risk of MI probably due to the inhibition of prostacyclin formation. This risk can be reduced by concomitant aspirin use. It was suggested that the incomplete reversal of risk with NSAIDS may be due to the pharmacodynamic interference of these NSAIDS with the binding of aspirin to platelet COX-1. It was also suggested that further evaluation of the potentially-increased GI toxicity of aspirin-NSAID therapy was needed.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2006 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/6\/3\/14.2.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzm5dd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}