Cardiovascular risk with cyclooxygenase inhibitors: general problem with substance specific differences?
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Randomised clinical trials and observational studies have shown an increased risk of myocardial infarction, stroke, hypertension and heart failure during treatment with cyclooxygenase inhibitors. Adverse cardiovascular effects occurred mainly, but not exclusively, in patients with concomitant risk factors. Cyclooxygenase inhibitors cause complex changes in renal, vascular and cardiac prostanoid profiles thereby increasing vascular resistance and fluid retention. The incidence of cardiovascular adverse events tends to increase with the daily dose and total exposure time. A comparison of individual selective and unselective cyclooxygenase inhibitors suggests substance-specific differences, which may depend on differences in pharmacokinetic parameters or inhibitory potency and may be contributed by prostaglandin-independent effects. Diagnostic markers such as N-terminal pro brain natriuretic peptide (NT-proBNP) or high-sensitive C-reactive protein might help in the early identification of patients at risk, thus avoiding the occurrence of serious cardiovascular toxicity.
- Cardiovascular risk with cyclooxygenase inhibitors: general problem with substance specific differences?
Naunyn-Schmiedeberg's Archives of Pharmacology
Volume 373, Issue 1 , pp 1-17
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Cyclooxygenase inhibitor
- Cardiovascular adverse event
- Heart failure
- Industry Sectors