Cardiovascular risks of COX inhibition: current perspectives.
BACKGROUND
NSAIDs are among the most commonly used pharmacotherapeutic agents worldwide. As the long-term use of these drugs is associated with serious gastrointestinal side effects, a new subgroup of COX-2 selective NSAIDs was developed. It was thought that the therapeutic strategy underlying the development of these newer compounds would enable them to provide the same analgesic and anti-inflammatory benefits as those of their traditional counterparts but perhaps offer a much safer gastrointestinal profile. Much scientific data has accumulated over the last few years, however, raising concerns regarding the increased cardiovascular complications associated with the use of COX-2 selective NSAIDs, and perhaps of the traditional NSAIDs as well.


OBJECTIVE
To review current and emerging evidence related to the cardiovascular effects of COX inhibitors and examine the clinical implications.


METHODS
We studied data from basic clinical research, non-randomized analyses, and randomized trials of COX inhibitors that investigated their cardiovascular effects.


CONCLUSIONS
Both COX-2 selective and traditional NSAIDs are associated with a moderately increased risk of cardiovascular events.
Farooq
Mohsin
M
University Hospitals of Leicester, Department of Cardiology, Leicester LE3 9QP, UK. m.farook@ntlworld.com
Haq
I
I
Qureshi
Amer S
AS
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D002986:Clinical Trials as Topic; D051546:Cyclooxygenase 2 / Q000187:drug effects; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects*; D006801:Humans; D012306:Risk; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D051546:Cyclooxygenase 2