Dalal D, et al. - A population-based nested case-control study is carried out to evaluate the risk of myocardial infarction (MI) related to meloxicam. According to the outcome obtained, meloxicam increased the risk of MI by 38% in this large population-based study. This study warrants cautious utilization of this increasingly popular drug.

• For this research, they performed a nested matched case-control study.
• They used Health Improvement Network.
• A UK population-based database was conducted.
• In this study, they included NSAID users between 35 and 89 years of age with not less than 1 year enlistment in the cohort.
• Incident MI cases were matched on age, sex, practice and event date with up to 4 controls.
• NSAID exposure was categorized as remote (between 60 days and 1 year), recent (between 1 and 60 days) or current relative to the event date.
• Current users were further classified as naproxen (negative control), diclofenac (positive control), meloxicam or other NSAID users.
• Multivariable conditional logistic regression was conducted to ascertain the risk of MI for each NSAID use categories compared with that of remote users.
• 9291 MI cases were matched with 30,676 controls.
• The cases had a higher prevalence of traditional cardiac risk factors, chronic kidney disease and inflammatory arthritis and cardioprotective drug utilization.
• The adjusted odds ratio of MI for current user compared to remote users were: meloxicam 1.38 (1.17-1.63), naproxen 1.12 (0.96-1.30) and diclofenac 1.37 (1.25-1.50).