Evidence map›Paper›PMID 31629022›Full record

ArticleOsteoarthritis and cartilage2020

Association of tramadol with risk of myocardial infarction among patients with osteoarthritis.

J Wei, M J Wood, M Dubreuil, G Tomasson, M R LaRochelle, C Zeng, N Lu, J Lin, H K Choi, G Lei and 1 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Osteoarthritis and cartilage, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
3.9field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Article
  5. Article
  6. Article
  7. Nonsteroidal Antiinflammatory Drugs and Susceptibility to COVID-19.Arthritis & rheumatology (Hoboken, N.J.) · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 9 institutions in 4 countries.

J WeiHealth Management Center, Xiangya Hospital, Central South University, Changsha, Hunan, China; Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: weij1988@csu.edu.cn.
M J WoodDivision of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: MJWOOD@mgh.harvard.edu.
M DubreuilBoston University School of Medicine, Boston, MA, USA; VA Boston Healthcare System, Boston, MA, USA. Electronic address: mdubreui@bu.edu.
G TomassonDepartment of Public Health Sciences, University of Iceland, Stapi Hringbraut, 101 Reykjavik, Iceland. Electronic address: gunnar.tomasson@gmail.com.
M R LaRochelleClinical Addiction Research and Education Unit at Boston University School of Medicine and Boston Medical Center, Boston, MA, USA. Electronic address: Marc.LaRochelle@bmc.org.
C ZengDivision of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: CZENG6@mgh.harvard.edu.
N LuDivision of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Arthritis Research Canada, Richmond, British Columbia, Canada. Electronic address: nhleo@channing.harvard.edu.
J LinDepartment of Orthopaedic Surgery, Peking University People's Hospital, Beijing, China. Electronic address: linjianhao@pkuph.edu.cn.
H K ChoiDivision of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: hchoi@partners.org.
G LeiDepartment of Orthopaedic Surgery, Peking University People's Hospital, Beijing, China; National Clinical Research Center of Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: lei_guanghua@csu.edu.cn.
Y ZhangDivision of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; The Mongan Institute, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: yzhang108@mgh.harvard.edu.
Harvard University · USBoston Medical Center · USMassachusetts General Hospital · USPeking University · CNPeking University People's Hospital · CNResearch Canada · CAUniversity of Iceland · ISVA Boston Healthcare System · USXiangya Hospital Central South University · CN

Funding

WORK DISABILITY-- PERSONS WITH RHEUMATOID ARTHRITISP60AR047785 · NIAMS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI FELSON, DAVID TOBIN · 2001 to 2016
$18.0M
Research and Evaluation Support Core Unit (RESCU Core)P30AR072571 · NIAMS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI TUHINA NEOGI · 2019 to 2026
$6.9M
Improving urine drug test utility to mitigate prescription opioid riskK23DA042168 · NIDA · BOSTON MEDICAL CENTER · PI LAROCHELLE, MARC · 2017 to 2021
$956k
Establishing the Value of Treatment Strategies in SpondyloarthritisK23AR069127 · NIAMS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI DUBREUIL, MAUREEN · 2016 to 2020
$848k
NIAMS NIH HHS K23 AR069127NIAMS NIH HHS P30 AR072571NIAMS NIH HHS P60 AR047785NIDA NIH HHS K23 DA042168
6 · The paper itself

Abstract

objectiveTramadol has been widely used among patients with osteoarthritis (OA); however, there is paucity of information on its cardiovascular risk. We aimed to examine the association of tramadol with risk of myocardial infarction (MI) among patients with OA.

designAmong OA patients aged 50-90 years without history of MI, cancer, or opioid use disorder in The Health Improvement Network database in the United Kingdom (2000-2016), three sequential propensity-score matched cohort studies were assembled, i.e., (1) patients who initiated tramadol or naproxen (negative comparator); (2) patients who initiated tramadol or diclofenac (positive comparator); and (3) patients who initiated tramadol or codeine (a commonly used weak opioid). The outcome was incident MI over six-months.

resultsAmong tramadol and naproxen initiators (n = 33,024 in each cohort), 77 (4.8/1000 person-years) and 46 (2.8/1000 person-years) incident MI occurred, respectively. The rate difference (RD) and hazard ratios (HR) for incident MI with tramadol initiation were 1.9 (95% confidence interval [CI] 0.6 to 2.3)/1000 person-years and 1.68 (95% CI 1.16 to 2.41) relative to naproxen initiation, respectively. Among tramadol and diclofenac initiators (n = 18,662 in each cohort), 58 (6.4/1000 person-years) and 47 (5.1/1000 person-years) incident MIs occurred, respectively. The corresponding RD and HR for incident MI were 1.2 (95%CI -2.1 to 14.1)/1000 person-years and 1.24 (95%CI 0.84 to 1.82), respectively. Among tramadol and codeine initiators (n = 42,722 in each cohort), 127 (6.1/1000 person-years) and 103 (5.0/1000 person-years) incident MI occurred, respectively, and the corresponding RD and HR were 1.1 (95%CI:-0.3 to 2.5)/1000 person-years and 1.23 (95%CI:0.95 to 1.60), respectively.

conclusionsIn this population-based cohort of patients with OA, the six-month risk of MI among initiators of tramadol was higher than that of naproxen, but comparable to, if not lower than, those of diclofenac or codeine.

Indexed as

AgedAged, 80 and overAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalCodeineDiclofenacFemaleHumansIncidenceMaleMiddle AgedMyocardial InfarctionNaproxenOsteoarthritisPropensity ScoreProportional Hazards ModelsAnalgesics, OpioidAnti-Inflammatory Agents, Non-SteroidalCodeineDiclofenacNaproxenTramadolCohortMyocardial infarctionOsteoarthritisTramadol

Identifiers

PMID31629022
PMCPMC7047659
OpenAlexW2980421439

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.