Key result
Short-term prescription of celecoxib after cardiac surgery with cardiopulmonary bypass was not associated with an increased risk of cardiovascular events or death compared to acetaminophen (HR 0.76).
Why the study?
Long-term selective cyclooxygenase-2 inhibitors increase cardiovascular risk, but whether short-term celecoxib increases cardiovascular events after cardiac surgery with cardiopulmonary bypass remained unclear.
Does short-term prescription of celecoxib increase cardiovascular events or death in adult patients who have undergone cardiac surgery with cardiopulmonary bypass compared to acetaminophen?
Cohort (n=5,906)
Yes
Does short-term prescription of celecoxib increase cardiovascular events or death in adult patients who have undergone cardiac surgery with cardiopulmonary bypass compared to acetaminophen?
Short-term prescription of celecoxib after non-CABG cardiac surgery with cardiopulmonary bypass does not appear to increase the risk of cardiovascular events or death compared to acetaminophen.
BACKGROUND: Cardiac surgery is a highly invasive procedure resulting in hypercoagulability due to thoracotomy and cardiopulmonary bypass (CPB). The long-term use of selective cyclooxygenase-2 inhibitors has been shown to increase the risk of adverse cardiovascular (CV) events such as myocardial infarction. This study aimed to determine whether short-term prescription of celecoxib increases CV events in patients who have undergone cardiac surgery with CPB. METHODS: This retrospective observational study included 16,141 patients (≥20 years) who had undergone cardiac surgery with CPB between April 1, 2008 and March 31, 2016. Patients who underwent coronary artery bypass grafting were excluded. Patients who received celecoxib (n = 904) and acetaminophen (n = 5,002) from postoperative day 0 to 30 were extracted and matched by propensity score (PS). The primary outcomes were all-cause death and CV events, defined as coronary artery disease, ischemic stroke, pulmonary embolism, and venous thrombosis, coded using International Classification of Diseases-10 within 30 days after the first postoperative prescription of either medication. Results were assessed using Kaplan-Meier survival analysis and multivariate Cox regression analysis. RESULTS: PS matching created 885 pairs. Multivariate Cox regression analysis showed that prescription of celecoxib after cardiac surgery was not associated with an increase in the primary outcomes when compared with prescription of acetaminophen (hazard ratio, 0.76; 95% confidence interval, 0.35-1.65). CONCLUSIONS: The prescription of celecoxib in patients who had undergone cardiac surgery with cardiopulmonary bypass was not statistically different from the prescription of acetaminophen in the incidence of CV events and death.
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Nahara et al. (2021) conducted a cohort in Cardiac surgery with cardiopulmonary bypass (n=5,906). Celecoxib vs. Acetaminophen was evaluated on Composite of all-cause death and cardiovascular events (coronary artery disease, ischemic stroke, pulmonary embolism, and venous thrombosis) within 30 days (HR 0.76, 95% CI 0.35-1.65, p=0.53). Short-term prescription of celecoxib after cardiac surgery with cardiopulmonary bypass was not associated with an increased risk of cardiovascular events or death compared to acetaminophen (HR 0.76).
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