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Evaluation of the risk of cardiovascular events with clarithromycin using both propensity score and self-controlled study designs
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Root, Adrian A., Wong, Angel Y. S., Ghebremichael Weldeselassie, Yonas, Smeeth, Liam, Bhaskaran, Krishnan, Evans, Stephen J. W., Brauer, Ruth, Wong, Ian Chi Kei, Navaratnam, Vidya and Douglas, Ian (2016) Evaluation of the risk of cardiovascular events with clarithromycin using both propensity score and self-controlled study designs. British Journal of Clinical Pharmacology, 82 (2). pp. 512-521. doi:10.1111/bcp.12983 ISSN 0306-5251.
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Official URL: http://dx.doi.org/10.1111/bcp.12983
Abstract
Aim:
Some previous studies suggest a long term association between clarithromycin use and cardiovascular events. This study investigates this association for clarithromycin given as part of Helicobacter pylori treatment (HPT).
Methods:
Our source population was the Clinical Practice Research Datalink (CPRD), a UK primary care database. We conducted a self‐controlled case series (SCCS), a case–time–control study (CTC) and a propensity score adjusted cohort study comparing the rate of cardiovascular events in the 3 years after exposure to HPT containing clarithromycin with exposure to clarithromycin free HPT.
Outcomes were first incident diagnosis of myocardial infarction (MI), arrhythmia and stroke. For the cohort analysis we included secondary outcomes all cause and cardiovascular mortality.
Results:
Twenty‐eight thousand five hundred and fifty‐two patients were included in the cohort. The incidence rate ratio of first MI within 1 year of exposure to HPT containing clarithromycin was 1.07 (95% CI 0.85, 1.34, P = 0.58) and within 90 days was 1.43 (95% CI 0.99, 2.09 P = 0.057) in the SCCS analysis. CTC and cohort results were consistent with these findings.
Conclusions:
There was some evidence for a short term association for first MI but none for a long term association for any outcome.
Item Type: | Journal Article | ||||||||||||
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Subjects: | R Medicine > RC Internal medicine R Medicine > RM Therapeutics. Pharmacology |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Antibiotics -- Side effects -- Great Britain, Cardiovascular system -- Diseases, Arrhythmia, Cerebrovascular disease | ||||||||||||
Journal or Publication Title: | British Journal of Clinical Pharmacology | ||||||||||||
Publisher: | Wiley-Blackwell Publishing Ltd. | ||||||||||||
ISSN: | 0306-5251 | ||||||||||||
Official Date: | August 2016 | ||||||||||||
Dates: |
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Volume: | 82 | ||||||||||||
Number: | 2 | ||||||||||||
Page Range: | pp. 512-521 | ||||||||||||
DOI: | 10.1111/bcp.12983 | ||||||||||||
Status: | Peer Reviewed | ||||||||||||
Publication Status: | Published | ||||||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||||||
Date of first compliant deposit: | 10 May 2018 | ||||||||||||
Date of first compliant Open Access: | 10 May 2018 | ||||||||||||
RIOXX Funder/Project Grant: |
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