The effect of COX-2-selective XXXX on the myocardial, vascular and renal risks: a systematic review.

@entity32 @entity13586 @entity12698 @entity3522 @entity5018 @entity117 @entity3352 @entity1623 @entity9213
PURPOSE: @entity32 ( @entity32 ) are known to increase the risk of cardiovascular (CV) and renal incidences,  especially  at higher doses and upon long term use. However, the available reports are criticized for lack of specificity, grouping of vastly different outcomes together and ignoring the heterogeneity among @entity32 . In this systematic review, we are reporting CV/renal risks associated with @entity9213 , stratified into myocardial, vascular, renal risk categories, to address the differential nature of @entity32 effects on different body systems. We are also reporting composite CV/renal risk to present overall risk associated with various covariates. METHODS: We searched  the online healthcare databases for observational studies or randomized controlled trials, reporting myocardial or all-cause mortality outcome (>90  days exposure) and/or vascular/renal outcomes (any exposure) after @entity9213 use, published until April 2014. The combined odd ratio values (OR'; 95  % CI) were calculated using the random effect inverse variance model. RESULTS: We found 19 eligible studies  out of 2,422  reports. @entity9213 demonstrated a low increase in composite risk (OR' 1.14; CI 1.04-1.25) which was mainly vascular in nature (OR' 1.35; CI 1.18-1.55] as it did not elevate myocardial (OR' 1.13; CI 0.98-1.32) or renal (OR', 0.99; CI 0.72-1.35) risks. Relative to @entity9213 , other @entity32 increased the composite risk, in a dose-dependent fashion, in the following order: @entity13586  >  @entity3352  >  @entity3522  >  @entity12698  >  @entity1623  >  @entity5018 . OR' was also influenced by type of disease and the comparator used, and @entity117 . CONCLUSION: @entity32 are heterogeneous in increasing CV/renal risks. The low increased risk associated with @entity9213 is mainly vascular in origin.
