Association of tramadol with all-cause mortality, cardiovascular diseases, venous thromboembolism, and hip fractures among patients with osteoarthritis: a population-based study

Table 4 Cardiovascular disease (myocardial infarction or ischemic stroke) risk within 1 year among patients initiating tramadol compared with other propensity score-matched analgesics among patients with OA

	Group 1		Group 2		Group 3		Group 4
	Tramadol cohort (n=10735)	Naproxen cohort (n=10735)	Tramadol cohort (n=13724)	Diclofenac cohort (n=13724)	Tramadol cohort (n=13670)	Cox-2 inhibitors cohort (n=13670)	Tramadol cohort (n=6066)	Codeine cohort (n=6066)
Cardiovascular diseases
Event (n)	187	218	263	254	256	251	95	102
Mean follow-up (years)	0.98	0.98	0.98	0.98	0.98	0.98	0.98	0.98
Rate, per 1000 PY	17.4	20.3	19.2	18.5	18.7	18.4	15.7	16.8
RD (95% CI), per 1000 PY	−2.9 (−6.7–0.7)	1.0 (ref)	0.7 (−2.6–4.0)	1.0 (ref)	0.5 (−2.8–3.8)	1.0 (ref)	−1.2 (−5.8–3.4)	1.0 (ref)
HR (95% CI)	0.9 (0.7–1.0)	1.0 (ref)	1.0 (0.9–1.2)	1.0 (ref)	1.0 (0.9–1.2)	1.0 (ref)	0.9 (0.8–1.1)	1.0 (ref)
Myocardial infarction
Event (n)	114	135	163	179	155	132	51	55
Mean follow-up (years)	0.98	0.98	0.98	0.99	0.98	0.99	0.98	0.98
Rate, per 1000 PY	10.2	12.1	11.4	12.5	11.0	9.3	8.2	8.8
RD (95% CI), per 1000 PY	−1.9 (−4.7–0.9)	1.0 (ref)	−1.1 (−3.7–1.5)	1.0 (ref)	1.7 (−0.7–4.1)	1.0 (ref)	−0.6 (−3.9–2.6)	1.0 (ref)
HR (95% CI)	0.9 (0.7–1.0)	1.0 (ref)	0.9 (0.8–1.1)	1.0 (ref)	1.2 (1.0–1.4)	1.0 (ref)	0.9 (0.7–1.2)	1.0 (ref)
Ischemic stroke
Event (n)	101	97	117	105	128	135	50	57
Mean follow-up (years)	0.98	0.99	0.98	0.99	0.98	0.99	0.95	0.95
Rate, per 1000 PY	9.6	9.2	8.7	7.8	9.6	10.1	8.4	9.6
RD (95% CI), per 1000 PY	0.4 (−2.3–3.1)	1.0 (ref)	0.9 (−1.3–3.1)	1.0 (ref)	−0.5 (−2.9–1.9)	1.0 (ref)	−1.2 (−4.7–2.2)	1.0 (ref)
HR (95% CI)	1.0 (0.8–1.2)	1.0 (ref)	1.1 (0.9–1.3)	1.0 (ref)	1.0 (0.8–1.1)	1.0 (ref)	0.9 (0.7–1.1)	1.0 (ref)

Abbreviations: OA osteoarthritis, PY person-years, RD rate difference, HR hazard ratio

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