Excess of MACCE in Aspirin and Dipyrone (Metamizole/Novalgin) Co-Medicated Patients: A Nationwide Study
| Autor: | Martin Pöhl, Christof Dücker, Ursula Marschall, Helmut L'Hoest, Kajetan Trojovsky, Amin Polzin, Thomas Hohlfeld, Karsten Schrör, Beata Hennig, Carolin Helten, Saif Zako, Christian Jung, Malte Kelm, Tobias Zeus, Daniel Metzen, Philipp Mourikis, Lisa Dannenberg, Bodo Levkau, Tobias Petzold |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Aspirin 050208 finance business.industry 05 social sciences Hazard ratio Number needed to harm medicine.disease Metamizole Confidence interval 3. Good health Internal medicine 0502 economics and business medicine Platelet activation Myocardial infarction 050207 economics business Stroke medicine.drug |
| Zdroj: | SSRN Electronic Journal. |
| ISSN: | 1556-5068 |
| Popis: | Background: Acute and chronic pain is a major issue in aging society. Dipyrone (metamizole, novalgin) is one of the most frequently used analgesics in many countries, despite that it may cause agranulocytosis. Additionally, it has recently been shown to impair pharmacodynamic response to aspirin measured by platelet function tests. However, it is not known if this laboratory effect translates to clinical outcome. Methods: We conducted a nation-wide analysis of a health insurance database in Germany comprising 9.2 million patients. All patients with a cardiovascular event in 2014 and subsequent secondary prevention with aspirin were followed-up for 36 months. Inverse probability of treatment weighting (IPTW) analysis was conducted to investigate major adverse cardio- and cerebrovascular events (MACCE; composite of death, myocardial infarction [MI], stroke/transient ischemic attack [TIA]) between patients on aspirin-dipyrone co-medication and on aspirin-alone medication. Results: 26,200 patients received permanent aspirin-alone medication and 5,946 patients aspirin-dipyrone co-medication. In the inverse probability of treatment weighted sample MACCE was more frequent in aspirin-dipyrone co-medicated patients (24.9% vs. 33.9%; hazard ratio [HR]=1.45, 95% confidence interval [CI] 1.38-1.53; p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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