Mohsin Farooq1, I Haq, Amer S Qureshi. 1. University Hospitals of Leicester, Department of Cardiology, Leicester LE3 9QP, UK. m.farook@ntlworld.com
Abstract
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. METHOD: We studied data from basic clinical research, non-randomized analyses, and randomized trials of COX inhibitors that investigated their cardiovascular effects. CONCLUSION: Both COX-2 selective and traditional NSAIDs are associated with a moderately increased risk of cardiovascular events.
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. METHOD: We studied data from basic clinical research, non-randomized analyses, and randomized trials of COX inhibitors that investigated their cardiovascular effects. CONCLUSION: Both COX-2 selective and traditional NSAIDs are associated with a moderately increased risk of cardiovascular events.
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