title: A cohort study to evaluate cardiovascular risk of selective and nonselective cyclooxygenase inhibitors (COX-Is) in arthritic patients attending orthopedic department of a tertiary care hospital.
abstract: BACKGROUND
  Cyclooxygenase-2 inhibitors (COX-2-Is) have recently been concerned in the occurrence of adverse cardiovascular (CV) events. Rofecoxib and valdecoxib has been withdrawn from the market, but celecoxib, etoricoxib and parecoxib continues to be used. Other nonsteroidal anti-inflammatory drugs (NSAIDs) may also increase the risk of CV events. However, clinical trial databases for COX-2-Is had created lots of controversies regarding cardiovascular safety of selective and nonselective cyclooxygenase inhibitors (COX-Is). This study was, conducted to assess and compare the CV risk of COX-Is in arthritic patients over a period of time.
  
  
  METHODS
  In this prospective cohort study adult arthritics of either sex those 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 treatment they received. The CV risk factors like blood pressure (BP), blood sugar level (BSL), lipid profile, body mass index (BMI) were assessed and compared; demography of CV risk factors was also studied. Data obtained was analysed using Student's 't'-test of OpenEpi statistical software.
  
  
  RESULTS
  Study clearly revealed that all NSAIDs exhibit variable CV risk; however, selective COX-2-Is found to exhibit more CV risk. BMI, BP and lipid profile; the potential CV risk factors, showed significant impairment in selective COX-2-Is group; P < 0.01, P < 0.001 and P < 0.05, respectively, compared to baseline and P < 0.05 vs. nonselective COX-Is for BMI.
  
  
  CONCLUSIONS
  This study portrays the potential CV risk of selective COX-2-Is; confirms and re-evaluate the results of earlier studies in this regard.
authors.affiliation: Department of Pharmacology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, Maharashtra, India.
authors.forename: Uma A
authors.initials: UA
authors.lastname: Bhosale
authors.affiliation: Department of Pharmacology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, Maharashtra, India.
authors.forename: Nilofar
authors.initials: N
authors.lastname: Quraishi
authors.affiliation: Department of Pharmacology, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, Maharashtra, India.
authors.forename: Radha
authors.initials: R
authors.lastname: Yegnanarayan
authors.affiliation: Department of Orthopedics, Smt. Kashibai Navale Medical College and General Hospital, Narhe, Pune, Maharashtra, India.
authors.forename: Dileep
authors.initials: D
authors.lastname: Devasthale
keywords: Body mass index; cardio-vascular risk; cyclooxygenase inhibitors; lipid profile