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首页> 外文期刊>Pharmacoepidemiology and drug safety >Parenteral ketorolac and risk of myocardial infarction.
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Parenteral ketorolac and risk of myocardial infarction.

机译：肠胃外的酮咯酸和心肌梗塞的风险。

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PURPOSE: To examine the effects of ketorolac, a non-aspirin non-steroidal anti-inflammatory drug (NANSAID) with antiplatelet properties, on the risk of in-hospital myocardial infarction (MI). METHODS: A retrospective cohort study was performed among hospitalized patients given 10,219 courses of parenteral ketorolac and patients given 10,145 courses of parenteral opioids, without ketorolac, in 35 hospitals. Patients were matched by hospital, admitting service, and date of study drug initiation. Any MI documented in the chart that occurred during the drug course and up to 3 days after the last dose was recorded by trained abstractors. RESULTS: MI occurred in 18 (0.2%) ketorolac and 45 (0.4%) opioid courses (odds ratio (OR) 0.40, 95% confidence interval (CI) 0.23-0.69). This negative association persisted in multivariable analysis adjusting for age, sex, history of diabetes mellitus or cardiovascular disease, and administration of antiplatelet agents (OR 0.42; 95% CI 0.24-0.73). The association also persisted in numerous analyses excluding patients who may have been treated with analgesics for ischemic pain, and when restricting events to those occurring while on the drug (OR 0.34; 95% CI 0.17-0.69). CONCLUSION: These results are consistent with a protective effect of ketorolac against MI. Future research that implements uniform screening for and independent validation of MIs as well as eliminates possible confounding by indication is the next logical step in confirming these findings.
机译：目的：研究酮咯酸（一种具有抗血小板特性的非阿司匹林非甾体类抗炎药（NANSAID））对院内心肌梗塞（MI）风险的影响。方法：回顾性队列研究在35所医院中接受10,219疗程胃肠外阿片类药物的住院患者和接受10,145疗程无ketorolac胃肠外阿片类药物的患者。根据医院，入院服务和研究药物起始日期对患者进行匹配。图表中记录的在药物疗程中以及最后一次给药后3天之内发生的任何MI均由训练有素的摘要记录。结果：MI发生在18个（0.2％）酮咯酸和45个（0.4％）阿片类药物疗程中（优势比（OR）0.40，95％置信区间（CI）0.23-0.69）。这种负相关性持续存在于针对年龄，性别，糖尿病史或心血管疾病史以及抗血小板药物管理进行调整的多变量分析中（OR 0.42; 95％CI 0.24-0.73）。该协会还坚持进行了许多分析，不包括可能因镇痛而接受过镇痛药治疗的患者，以及将事件限制为使用药物时发生的事件（OR 0.34; 95％CI 0.17-0.69）。结论：这些结果与酮咯酸对MI的保护作用一致。未来的研究将对MIs进行统一筛选和独立验证，并消除适应症，这是确认这些发现的下一个逻辑步骤。

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