Risk of hyperkalemia associated with selective COX-2 inhibitors.
Risk of hyperkalemia associated with selective COX-2 inhibitors.
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DOI：
10.1002/pds.2011
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发表时间：
2010-11
影响因子：
2.6
通讯作者：
Murray, Michael D.
中科院分区：
文献类型：
--
作者：
Aljadhey, Hisham;Tu, Wanzhu;Hansen, Richard A.;Blalock, Susan;Brater, Craig;Murray, Michael D.
选择性环氧合酶-2（考克斯-2）抑制剂与心源性死亡有关。这种不良反应的机制似乎是缺血性损伤;然而，另一种机制可能涉及高钾血症。本研究的目的是确定选择性考克斯-2抑制剂和非选择性非甾体抗炎药（NSAID）对血清钾浓度和心电图的影响。一项回顾性队列研究使用倾向评分匹配的患者从内城学术医疗中心在印第安纳波利斯，印第安纳州。使用倾向评分方法，将202名服用选择性考克斯-2抑制剂的患者与202名服用非选择性非甾体抗炎药的患者进行匹配。结果包括血清钾浓度较基线的变化和心电图异常的风险。与使用非选择性NSAID的患者相比，使用选择性考克斯-2抑制剂的患者血清钾升高大于5 mEq/L的风险更高（OR，2.56; 95%CI，1.03-6.36）。然而，选择性考克斯-2抑制剂的患者心电图异常的风险并没有增加（OR，1.16; 95%CI，0.74-1.82）。选择性考克斯-2抑制剂可能比非选择性NSAID具有更大的高钾血症风险。本研究为探索性研究，患者数量较少。需要进一步的研究来证实这些结果以及与心血管事件的任何关联。
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. 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. 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). 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.
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