Preoperative celecoxib use does not increase risk of myocardial infarction and may be protective against thromboembolic complications following total joint arthroplasty

Purpose: The purpose of this study was to determine if preoperative celecoxib treatment raises the risk of postoperative 1) myocardial infarctions, 2) thromboembolic complications, 3) acute kidney injuries, 4) transfusions, and 5) readmissions. Materials and methods: Using the administrative claims...

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Main Authors: Matthew L. Magruder, Shabnam Parsa, Ariel N. Rodriguez, Mitchell Ng, Che Hang Jason Wong
Format: Article
Language:English
Published: Elsevier 2025-03-01
Series:Journal of Orthopaedic Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2773157X24000687
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author Matthew L. Magruder
Shabnam Parsa
Ariel N. Rodriguez
Mitchell Ng
Che Hang Jason Wong
author_facet Matthew L. Magruder
Shabnam Parsa
Ariel N. Rodriguez
Mitchell Ng
Che Hang Jason Wong
author_sort Matthew L. Magruder
collection DOAJ
description Purpose: The purpose of this study was to determine if preoperative celecoxib treatment raises the risk of postoperative 1) myocardial infarctions, 2) thromboembolic complications, 3) acute kidney injuries, 4) transfusions, and 5) readmissions. Materials and methods: Using the administrative claims database, PearlDiver, a retrospective study from January 2010 to October 2020 was conducted. Patients undergoing total knee or hip arthroplasty for osteoarthritis with recent celecoxib prescription were included, excluding those with MI history. Propensity score matched 230,587 patients (TKA: 38,433 celecoxib, 192,154 control; THA: 21,603 celecoxib, 108,008 control). Outcomes evaluated: 90-day myocardial infarction, DVT, PE, VTE, AKIs, transfusion, readmission. Multivariate logistic regression calculated odds ratios, 95 % CIs, p-values. Welch's t-tests assessed differences in stay lengths, costs (p < 0.001 threshold). Results: Celecoxib-treated patients showed comparable postoperative MI rates after TKA (0.16 % vs 0.23 %; OR 0.72; p = 0.018) and THA (0.25 % vs 0.22 %; OR 1.14; p = 0.359) versus controls. In TKA, celecoxib correlated with lower DVT (3.11 % vs 3.25 %; OR 0.95; p < 0.001) and transfusion (5.57 % vs 7.09 %; OR 0.76; p < 0.001) rates. PE (2.56 % vs 2.71 %; OR 0.94; p = 0.106), VTE (4.45 % vs 4.77 %; OR 0.93; p = 0.008), and readmission (5.35 % vs 5.39 %; OR 0.99; p = 0.73) showed no significant difference. In THA, celecoxib linked to lower DVT (2.57 % vs 3.02 %; OR 0.84; p < 0.001), VTE (3.64 % vs 4.30 %; OR 0.83; p < 0.001), transfusion (6.57 % vs 10.09 %; OR 0.65; p < 0.001), and readmission (5.49 % vs 6.06 %; OR 0.89; p = 0.001); PE (2.10 % vs 2.40 %; OR 0.87; p = 0.007) showed no significant difference. Conclusion: Celecoxib use showed no heightened risk of postoperative TKA and postoperative THA myocardial infarctions. Additionally, the celecoxib group exhibited notably reduced or insignificantly different rates of DVT, PE, VTE, transfusions, and readmissions.
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spelling doaj-art-df80ba1d0f4f4b91886d013e51c24eb02025-08-20T03:42:19ZengElsevierJournal of Orthopaedic Reports2773-157X2025-03-014110037310.1016/j.jorep.2024.100373Preoperative celecoxib use does not increase risk of myocardial infarction and may be protective against thromboembolic complications following total joint arthroplastyMatthew L. Magruder0Shabnam Parsa1Ariel N. Rodriguez2Mitchell Ng3Che Hang Jason Wong4Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USARenaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Corresponding author.Maimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USAMaimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USAMaimonides Medical Center, Department of Orthopaedic Surgery, Brooklyn, NY, USAPurpose: The purpose of this study was to determine if preoperative celecoxib treatment raises the risk of postoperative 1) myocardial infarctions, 2) thromboembolic complications, 3) acute kidney injuries, 4) transfusions, and 5) readmissions. Materials and methods: Using the administrative claims database, PearlDiver, a retrospective study from January 2010 to October 2020 was conducted. Patients undergoing total knee or hip arthroplasty for osteoarthritis with recent celecoxib prescription were included, excluding those with MI history. Propensity score matched 230,587 patients (TKA: 38,433 celecoxib, 192,154 control; THA: 21,603 celecoxib, 108,008 control). Outcomes evaluated: 90-day myocardial infarction, DVT, PE, VTE, AKIs, transfusion, readmission. Multivariate logistic regression calculated odds ratios, 95 % CIs, p-values. Welch's t-tests assessed differences in stay lengths, costs (p < 0.001 threshold). Results: Celecoxib-treated patients showed comparable postoperative MI rates after TKA (0.16 % vs 0.23 %; OR 0.72; p = 0.018) and THA (0.25 % vs 0.22 %; OR 1.14; p = 0.359) versus controls. In TKA, celecoxib correlated with lower DVT (3.11 % vs 3.25 %; OR 0.95; p < 0.001) and transfusion (5.57 % vs 7.09 %; OR 0.76; p < 0.001) rates. PE (2.56 % vs 2.71 %; OR 0.94; p = 0.106), VTE (4.45 % vs 4.77 %; OR 0.93; p = 0.008), and readmission (5.35 % vs 5.39 %; OR 0.99; p = 0.73) showed no significant difference. In THA, celecoxib linked to lower DVT (2.57 % vs 3.02 %; OR 0.84; p < 0.001), VTE (3.64 % vs 4.30 %; OR 0.83; p < 0.001), transfusion (6.57 % vs 10.09 %; OR 0.65; p < 0.001), and readmission (5.49 % vs 6.06 %; OR 0.89; p = 0.001); PE (2.10 % vs 2.40 %; OR 0.87; p = 0.007) showed no significant difference. Conclusion: Celecoxib use showed no heightened risk of postoperative TKA and postoperative THA myocardial infarctions. Additionally, the celecoxib group exhibited notably reduced or insignificantly different rates of DVT, PE, VTE, transfusions, and readmissions.http://www.sciencedirect.com/science/article/pii/S2773157X24000687CelecoxibTotal joint arthroplastyPostoperative complicationsMyocardial infarction
spellingShingle Matthew L. Magruder
Shabnam Parsa
Ariel N. Rodriguez
Mitchell Ng
Che Hang Jason Wong
Preoperative celecoxib use does not increase risk of myocardial infarction and may be protective against thromboembolic complications following total joint arthroplasty
Journal of Orthopaedic Reports
Celecoxib
Total joint arthroplasty
Postoperative complications
Myocardial infarction
title Preoperative celecoxib use does not increase risk of myocardial infarction and may be protective against thromboembolic complications following total joint arthroplasty
title_full Preoperative celecoxib use does not increase risk of myocardial infarction and may be protective against thromboembolic complications following total joint arthroplasty
title_fullStr Preoperative celecoxib use does not increase risk of myocardial infarction and may be protective against thromboembolic complications following total joint arthroplasty
title_full_unstemmed Preoperative celecoxib use does not increase risk of myocardial infarction and may be protective against thromboembolic complications following total joint arthroplasty
title_short Preoperative celecoxib use does not increase risk of myocardial infarction and may be protective against thromboembolic complications following total joint arthroplasty
title_sort preoperative celecoxib use does not increase risk of myocardial infarction and may be protective against thromboembolic complications following total joint arthroplasty
topic Celecoxib
Total joint arthroplasty
Postoperative complications
Myocardial infarction
url http://www.sciencedirect.com/science/article/pii/S2773157X24000687
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