Tags

Type your tag names separated by a space and hit enter

Nonsteroidal anti-Inflammatory drugs and cardiovascular risk.
J Am Coll Cardiol. 2004 Feb 18; 43(4):519-25.JACC

Abstract

Nonsteroidal anti-inflammatory drugs (NSAID) inhibit cyclooxygenase (COX) enzymes, which exist in at least two isoforms, COX-1 and COX-2. Aspirin and older agents in this class are nonselective inhibitors of both COX-1 and COX-2. Newer agents termed "coxibs" are selective inhibitors of COX-2. Among the NSAID, only aspirin has been proven to significantly reduce cardiovascular risk, primarily through inhibition of COX-1-mediated platelet aggregation. It has been suggested that other nonselective agents, especially naproxen, may provide some lesser degree of cardioprotection, but conclusive evidence is lacking. Conversely, there are concerns that the COX-2 inhibitors may increase cardiovascular risk. However, mechanisms for this potentially adverse cardiovascular effect are unknown, and it is becoming increasingly clear that our understanding of the role of COX-2 in cardiovascular function is incomplete. Some studies have demonstrated a potentially beneficial effect of COX-2 on cardiovascular function that could be negated by COX-2 inhibition, while other studies have reported improved endothelial function with COX-2 inhibitors. Additionally, the impact of combined therapy with aspirin and other COX inhibitors is not yet clear. This article will review the studies that have examined these issues.

Authors+Show Affiliations

Department of Pharmacy Practice, University of Kansas Medical Center, Kansas City, Kansas 66160-7231, USA. phoward@kumc.eduNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

14975457

Citation

Howard, Patricia A., and Patrice Delafontaine. "Nonsteroidal anti-Inflammatory Drugs and Cardiovascular Risk." Journal of the American College of Cardiology, vol. 43, no. 4, 2004, pp. 519-25.
Howard PA, Delafontaine P. Nonsteroidal anti-Inflammatory drugs and cardiovascular risk. J Am Coll Cardiol. 2004;43(4):519-25.
Howard, P. A., & Delafontaine, P. (2004). Nonsteroidal anti-Inflammatory drugs and cardiovascular risk. Journal of the American College of Cardiology, 43(4), 519-25.
Howard PA, Delafontaine P. Nonsteroidal anti-Inflammatory Drugs and Cardiovascular Risk. J Am Coll Cardiol. 2004 Feb 18;43(4):519-25. PubMed PMID: 14975457.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonsteroidal anti-Inflammatory drugs and cardiovascular risk. AU - Howard,Patricia A, AU - Delafontaine,Patrice, PY - 2003/03/06/received PY - 2003/06/03/revised PY - 2003/09/10/accepted PY - 2004/2/21/pubmed PY - 2004/3/16/medline PY - 2004/2/21/entrez SP - 519 EP - 25 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 43 IS - 4 N2 - Nonsteroidal anti-inflammatory drugs (NSAID) inhibit cyclooxygenase (COX) enzymes, which exist in at least two isoforms, COX-1 and COX-2. Aspirin and older agents in this class are nonselective inhibitors of both COX-1 and COX-2. Newer agents termed "coxibs" are selective inhibitors of COX-2. Among the NSAID, only aspirin has been proven to significantly reduce cardiovascular risk, primarily through inhibition of COX-1-mediated platelet aggregation. It has been suggested that other nonselective agents, especially naproxen, may provide some lesser degree of cardioprotection, but conclusive evidence is lacking. Conversely, there are concerns that the COX-2 inhibitors may increase cardiovascular risk. However, mechanisms for this potentially adverse cardiovascular effect are unknown, and it is becoming increasingly clear that our understanding of the role of COX-2 in cardiovascular function is incomplete. Some studies have demonstrated a potentially beneficial effect of COX-2 on cardiovascular function that could be negated by COX-2 inhibition, while other studies have reported improved endothelial function with COX-2 inhibitors. Additionally, the impact of combined therapy with aspirin and other COX inhibitors is not yet clear. This article will review the studies that have examined these issues. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/14975457/Nonsteroidal_anti_Inflammatory_drugs_and_cardiovascular_risk_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735109703015547 DB - PRIME DP - Unbound Medicine ER -