Table 1.
Characteristics of Case‐Control Studies in the Meta‐analysis
| Page et al11 | García‐Rodríguez et al13 | Huerta et al15 | Mangoni et al23 | |
|---|---|---|---|---|
| Country | Australia (New South Wales) | United Kingdom | United Kingdom | Australia |
| Year of publication | 2000 | 2003 | 2006 | 2010 |
| Study design | Case control | Case control | Case control | Case control |
| Cases | Patients who were admitted at the study hospitals with the primary diagnosis of HF from 1993 to 1995 were consecutively recruited. The study included patients both with and without prior diagnosis of heart diseases but also provided separate analysis for each category. | All patients age 40–84 y first diagnosed with HF between January 1, 1996, and December 31, 1996. Cases were identified from the United Kingdom General Practice Research Database, which covered approximately 3 million residents across the United Kingdom. Cases were verified by reviewing medical records. | All patients age 60–84 y first hospitalized with HF between January 1, 1997, and December 31, 2000. Cases were identified from the United Kingdom General Practice Research Database, which covered approximately 3 million residents across the United Kingdom. Cases were verified by reviewing medical records. The study included patients both with and without prior diagnosis of HF but also provided separate analysis for each category. | All patients age ≥65 y hospitalized with HF between January 1, 2002, and June 30, 2006. Cases were identified from the DVA database. DVA provided care with minimal copay to all Australian war veterans, spouses, and dependents. Cases with prior diagnosis of HF were excluded. |
| Controls | Sex‐ and age‐matched patients admitted at the same hospital. Controls must have no history of HF and must not have clinical or radiologic evidence of HF. | Sex‐ and age‐matched subjects without HF randomly selected from the same database | Sex‐ and age‐matched subjects without HF randomly selected from the same database | Sex‐, age‐, and state of residence–matched subjects without HF randomly selected from the same database |
| NSAIDs assessed in the study | Diclofenac, ibuprofen, ketoprofen, tiaprofenic acid, mefenamic acid, indomethacin, sulindac, diflunisal, naproxen, piroxicam, tenoxicam | Aceclofenac, acemetacin, diclofenac, etodolac, fenbufen, fenoprofen, flurbiprofen, ibuprofen, indomethacin, ketoprofen, mefenamic acid, tiaprofenic acid, apazone, meloxicam, nabumetone, naproxen, piroxicam, sulindac, tenoxicam | Aceclofenac, acemetacin, azapropazone, diclofenac, diflunisal, etodolac, fenbufen, fenoprofen, flurbiprofen, ibuprofen, indomethacin, ketoprofen, mefenamic acid, tiaprofenic acid, apazone, meloxicam, nabumetone, naproxen, piroxicam, sulindac, tenoxicam | Diclofenac, naproxen, ibuprofen, meloxicam, diflunisal, piroxicam, indomethacin, ketoprofen, mefenamic acid, tiaprofenic acid, celecoxib, lumiracoxib, rofecoxib |
| Definition of NSAID exposure | Use of any NSAID within 1 week prior to admission | Supply of the most recent prescription listed within 30 days prior to the index date | Supply of the most recent prescription listed within 30 days prior to the index date | Supply of the most recent prescription listed within 30 days prior to the index date |
| Verification of NSAID exposure | Structured interview within 1 week of admission | Prescription information from the database | Prescription information from the database | Prescription information from the database |
| Cases, n | 76 | 471 | 428 | 18 903 |
| Controls, n | 478 | 2807 | 2420 | 376 633 |
| Female sex, %, cases/ controls | 45.8/46.8 | 48.0/48.0 | 48.0/48.0 | 34.7/34.7 |
| Average age, y, cases/ controls | 76.6/75.1 | NA | NA | 65.3/65.3 |
| Confounders adjusted for | History of renal disease, respiratory disease, and PAD; use of β‐blockers, calcium channel antagonists, antidiabetic drugs, oral steroids | Age, sex, BMI, smoking, alcohol; use of steroids, acetaminophen, anticoagulants; DM, COPD, CAD, asthma, renal failure, valvular diseases, rhythm disorders, HTN | Age, sex, calendar year, BMI, smoking, alcohol; use of steroids, acetaminophen, anticoagulants; DM, CAD, COPD, asthma, valvular diseases, rhythm disorders, renal failure, HTN, hospitalizations in previous year | Age; public or private hospital admissions (for DM, obesity, dementia, HTN, CAD, respiratory disease, liver disease, RA, or renal disease) at any time prior to the index date; use of salicylic acid and derivatives or medications for obesity, DM, CAD, dementia, and COPD within 4 months prior to index date |
| Newcastle‐Ottawa scale | Selection, 3 stars; comparability, 1 star; exposure, 3 stars | Selection, 4 stars; comparability, 1 star; exposure, 3 stars | Selection, 4 stars; comparability, 1 star; exposure, 3 stars | Selection, 3 stars; comparability, 1 star; exposure, 3 stars |
Abbreviations: BMI, body mass index; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; DM, diabetes mellitus; DVA, Department of Veterans' Affairs; HF, heart failure; HTN, hypertension; NA, not available; NSAIDs, nonsteroidal anti‐inflammatory drugs; PAD, peripheral arterial disease; RA, rheumatoid arthritis.