Rofecoxib, a COX-2 inhibitor, lowers C-reactive protein and interleukin-6 levels in patients with acute coronary syndromes.
BACKGROUND
Patients with acute coronary syndromes (ACS) have high levels of inflammatory mediators such as C-reactive protein (CRP) and interleukin (IL)-6.


OBJECTIVE
To evaluate whether patients with ACS treated with rofecoxib, a COX-2 inhibitor, will have reduced CRP, IL-6, and soluble tumor necrotic factor receptor-1 (sTNF-R1) levels and improved endothelial function.


RESULTS
Thirty-four patients hospitalized with ACS were randomized to receive rofecoxib, 25 mg/d plus aspirin 100 mg/d, or placebo plus aspirin, 100 mg/d, for a period of 3 months. Blood samples for CRP, IL-6, and sTNF-R1 levels were drawn prior to randomization, and after 1 month and 3 months. CRP levels in the rofecoxib group (n = 18) were significantly lower both at 1 month and 3 months compared to the baseline levels (p < 0.02). IL-6 levels were significantly lower at 1 month (p < 0.02) in the rofecoxib group, but not at 3 months. There was no change in endothelial function or sTNF-R1 levels.


CONCLUSIONS
Patients recovering from ACS had lower levels of CRP and IL-6 at 1 month and lower CRP levels at 3 months when treated with rofecoxib plus aspirin. Suppression of inflammatory processes may lead to retardation of coronary atherosclerosis and coronary events.
Monakier
Daniel
D
Department of Cardiology, Shaare Zedek Medical Center, Jerusalem, Israel.
Mates
Michal
M
Klutstein
Marc W
MW
Balkin
Jonathan A
JA
Rudensky
Bernard
B
Meerkin
David
D
Tzivoni
Dan
D
D000208:Acute Disease; D000789:Angina, Unstable / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D003327:Coronary Disease / Q000097:blood*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007783:Lactones / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D011446:Prospective Studies; D013450:Sulfones; D013577:Syndrome
D016861:Cyclooxygenase Inhibitors; D015850:Interleukin-6; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib; D002097:C-Reactive Protein