Chronic analgesic use with either COT or COX-2 was associated with an increased risk of cardiovascular outcomes. These findings suggest either a selection of high-risk patients to chronic analgesic treatment, coupled with unmeasured or residual confounding, or a potential cardiovascular effect of these medications. Further research is warranted to evaluate causes for this association.
The results from the monotherapy and the dual-therapy comparisons, though not individually significant, are consistent in suggesting that the risk of cardiovascular outcome events in patients using rosiglitazone may lie between the risks associated with sulfonylureas (higher incidence) and metformin (lower incidence).
Patients with HCV and cirrhosis of various etiologies are at increased risk of several types of thromboembolic events. Physicians should consider this increased risk when managing patients with liver disease.
There is a paucity of epidemiological data on the risk of comorbidities in adults with persistent or chronic immune thrombocytopenia (ITP). In this study, we compared the rates of cataracts, diabetes, renal failure, vascular events, lymphoma, and leukemia among patients with and without persistent or chronic ITP. Using administrative data, adult patients with medical claims for ITP from January, 2000 through September, 2006 were identified. An age- and gender-matched comparison cohort without evidence of ITP was randomly selected. The incidence rate ratio (IRR) of each comorbidity among ITP patients relative to the comparison group was estimated using Poisson regression, adjusting for baseline covariates. A total of 3,131 patients with persistent or chronic ITP were identified, and 9,392 were selected for the comparison cohort. The adjusted IRRs were as follows: diabetes 1.73 (95% CI 1.36-2.20), renal failure 2.05 (95% CI 1.67-2.51), any vascular event 1.70 (95% CI 1.41-2.05), lymphoma 5.91 (95% CI 2.61-13.37), leukemia 19.83 (95% CI 5.84-67.34), and mortality 4.21 (95% CI 3.06-5.79). There was no increased risk for cataract or myocardial infarction in the ITP cohort. Patients with persistent or chronic ITP are at increased risk for several comorbidities including hematologic malignancies, relative to a matched comparison cohort.
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