Related Experiment Videos
Cyclooxygenase-2 inhibitors: is there an association with coronary or renal events?
1Department of Experimental Cardiology, Huntington Medical Research Institutes, 99 North El Molino Avenue, Pasadena, CA 91101, USA. cardio@hmri.org
Abstract:
The article is concerned with the effects of specific cyclooxygenase-2 (COX-2) inhibitors and their relationship to thrombotic cardiovascular events and to renal disease. Clinical and experimental aspects of COX-2-specific inhibitors are cited. A COX-2 inhibitor, celecoxib, interferes with myocardial prostacyclin production and also produces hypertension. Data have shown that in animal experiments, celecoxib also lowers myocardial prostaglandin concentration but fails to inhibit thromboxane concentration to the same degree. In the kidney, celecoxib can result in glomerular and interstitial nephritis or papillary necrosis. As in infarcted heart muscle, the COX-2-specific inhibitor celecoxib causes a significant decline in prostaglandin in the renal medulla. It was concluded from both clinical and experimental findings that COX-2 inhibitors can cause thrombotic cardiovascular events as well as renal disease. For these reasons, care should be exercised in administering specific COX-2 inhibitors to patients with pre-existing cardiac or renal disease.
Insights
Specific cyclooxygenase-2 (COX-2) inhibitors, like celecoxib, are linked to increased risks of thrombotic cardiovascular events and kidney disease. Caution is advised when prescribing these drugs to patients with existing heart or kidney conditions.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Nephrology
Background:
- Cyclooxygenase-2 (COX-2) inhibitors are widely used for their anti-inflammatory properties.
- Concerns exist regarding their potential adverse effects on the cardiovascular and renal systems.
Purpose of the Study:
- To investigate the relationship between specific COX-2 inhibitors and thrombotic cardiovascular events.
- To examine the impact of COX-2 inhibitors on renal disease development.
Main Methods:
- Review of clinical data and experimental findings related to COX-2 inhibitors.
- Analysis of celecoxib's effects on myocardial prostacyclin and prostaglandin concentrations.
- Evaluation of celecoxib's impact on renal function and prostaglandin levels in animal models.
Main Results:
- Celecoxib interferes with myocardial prostacyclin production, leading to hypertension.
- Animal studies show celecoxib lowers myocardial prostaglandin but not thromboxane concentration.
- Celecoxib use is associated with renal pathologies including nephritis and papillary necrosis, and a decline in renal medulla prostaglandin.
Conclusions:
- Specific COX-2 inhibitors can precipitate thrombotic cardiovascular events and renal disease.
- Careful administration of COX-2 inhibitors is recommended for patients with pre-existing cardiac or renal conditions.