title: A comparative study to evaluate the cardiovascular risk of selective and nonselective cyclooxygenase inhibitors (COX-Is) in arthritic patients.
abstract: BACKGROUND
  During the past 2 years, a great deal of evaluation has been accomplished on the cardiovascular (CV) effects of nonsteroidal anti-inflammatory drugs (NSAIDs), nonselective and selective cyclooxygenase-2 inhibitors (COX-2-Is). Clinical trial databases for nonselective and selective COX-2-Is have shown variable effects on CV risk. There is much controversy regarding the CV safety of these selective and nonselective COX inhibitors (COX-Is). This study was therefore conducted to assess and compare the CV risk of COX-Is in arthritic patients over a period of time.
  
  
  METHODS
  In this prospective comparative study, adult arthritics of either sex who were freshly diagnosed or taking COX-Is for <3 months were included. Patients were grouped into nonselective and selective COX-2-I groups with reference to the treatment they received, whereas arthritics with no history of COX-I treatment were included as controls. CV risk factors like blood pressure (BP), blood sugar level (BSL), lipid profile, and body mass index (BMI) were assessed and compared; the demography of CV risk factors was also studied. Data obtained were analyzed with Student's t-test using OpenEpi statistical software (Andrew G. Dean and Kevin M. Sullivan, Atlanta, GA, USA).
  
  
  RESULTS
  The study clearly revealed that all NSAIDs exhibit potential CV risk; however, selective COX-2-Is were found to exhibit more CV risk. BMI, BP and lipid profile, the potential CV risk factors, showed significant impairment in a selective COX-2-I group: p<0.01, p<0.001 and p<0.05, respectively, vs. baseline and p<0.05 for BMI and triglycerides vs. nonselective COX-Is.
  
  
  CONCLUSIONS
  This study depicts the impending CV risk of selective COX-2-Is and confirms and reevaluates the results of earlier studies in this regard.
authors.forename: Uma A
authors.initials: UA
authors.lastname: Bhosale
authors.forename: Nilofar
authors.initials: N
authors.lastname: Quraishi
authors.forename: Radha
authors.initials: R
authors.lastname: Yegnanarayan
authors.forename: Dileep
authors.initials: D
authors.lastname: Devasthale
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000209:etiology; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors