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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/16993

Title: Risk of hyperkalemia associated with selective COX-2 inhibitors
Authors: Hisham Aljadhey
Richard A. Hansen
Susan Blalock
Keywords: NSAIDs; selective COX-2 inhibitors; retrospective cohort study, propensity score
Issue Date: 2010
Publisher: Pharmacoepidemiology and Drug Safety
Abstract: Background Selective cyclooxygenase-2 (COX-2) inhibitors have been linked to cardiac death. The mechanism for this adverse effect appears to be by ischemic insult; however another mechanism could involve hyperkalemia. The objective of this study was to determine the effects of selective COX-2 inhibitors and non-selective nonsteroidal anti-inflammatory drugs (NSAIDs) on serum potassium concentration and the electrocardiogram. Methods A retrospective cohort study was conducted using propensity score matching of patients from an inner-city academic medical center at Indianapolis, Indiana. Two hundred and two patients prescribed selective COX-2 inhibitors were matched to 202 patients prescribed non-selective NSAIDs using propensity scores methods. Outcomes included change in serum potassium concentration from baseline and the risk of an abnormal electrocardiogram. Results Compared to patients prescribed non-selective NSAIDs, those prescribed a selective COX-2 inhibitor had a higher risk of serum potassium increase greater than 5 mEq/L (OR, 2.56; 95%CI, 1.03–6.36). However, patients prescribed selective COX-2 inhibitors had no greater risk of electrocardiogram abnormality (OR, 1.16; 95%CI, 0.74–1.82). Conclusions Selective COX-2 inhibitors may have a greater risk of hyperkalemia than non-selective NSAIDs. This study was exploratory with small numbers of patients. Further studies are needed to confirm these results and any association with cardiovascular events. Copyright © 2010 John Wiley & Sons, Ltd.
URI: http://hdl.handle.net/123456789/16993
Appears in Collections:College of Pharmacy

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