Objective: To evaluate the relationship between the use of zolpidem and risk of subsequent AMI in Taiwanese patients.

Method: This case-control study used data obtained from the National Health Insurance Research Database to determine whether the use of zolpidem is associated with an increased risk of AMI. The case group comprised 5048 patients who were newly diagnosed with AMI between January 1, 2005, and December 31, 2010. We also randomly selected a 4-fold greater number of patients without AMI as a control group. Patients were frequency-matched with controls on sex, age, and year of index date. We measured the effect of zolpidem, and determined the adjusted odds ratios (ORs) with 95% confidence intervals (CIs).

Results: We found that exposure to zolpidem was associated with increased risk of AMI (OR=1.34; 95% CI, 1.25-1.45). The risk of AMI increased significantly with increasing exposure to zolpidem; for average exposures of ≦ 35, 35-134, 134-587, and > 587 mg/year, the ORs were 1.23, 1.27, 1.39 and 1.51, respectively; the P value for the trend was <0.0001. Regardless of whether people presented with a sleep disorder, the risk of AMI was still greatly increased with zolpidem exposure; the adjusted OR was 1.35 without sleep disorder and 1.33 with sleep disorder.

Conclusions: This population-based study positively associated the use of zolpidem with increased risk of AMI. Our findings warrant further large-scale and in-depth investigations in this area.