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Selective cyclooxygenase-2 (COX-2) inhibitors and potential risk of cardiovascular events
1Division of Cardiology, University Hospital, University of Michigan Health System, B1-F245, 1500 East Medical Center Drive, Ann Arbor, MI 48103-0022, USA. dmukherj@umich.edu
Abstract:
Selective cyclooxygenase-2 (COX-2) inhibitors were developed as a response to the gastrointestinal toxicity of conventional nonsteroidal anti-inflammatory agents (NSAIDs). However, COX-2 inhibitors decrease vascular prostacyclin (PGI(2)) production and may disrupt the homeostatic mechanisms that limit the effects of platelet activation. Basic and clinical data raise concerns about a potential prothrombotic effect of this class of drugs. The widespread popularity of these agents mandates their prospective evaluation in patients with cardiovascular diseases or who are at risk for cardiovascular events.
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