Cardiovascular thromboembolic adverse effects associated with cyclooxygenase-2 selective inhibitors and nonselective antiinflammatory drugs.

摘要: Background Concerns of increased cardiovascular (CV) thromboembolic adverse effects from nonsteroidal antiinflammatory drugs (NSAIDs, both nonselective [NS]-NSAIDs and cyclooxygenase [COX]-2 selective inhibitors) have prevented their use despite numerous benefits. Methods In this descriptive review, we critically examine the randomized, active- placebo-controlled studies, observational trials, meta-analyses evaluating CV associated with long-term short-term COX-2 inhibitors NS-NSAIDs. The potential mechanisms for these are also presented. Results Although studies risks limitations, there appears to be an risk NS-NSAIDs, particularly in high-risk patients. Therefore, United States Food Drug Administration has given a similar "boxed" warning highlighting events use. Nevertheless, differences between (e.g., higher rofecoxib than celecoxib) as well individual NS-NSAIDs diclofenac naproxen). Conclusions Until long-term, prospective, adequately powered, clinical relevant patient populations been completed, NSAIDs, especially patients, will likely continue controversial. benefits perioperative) patients without probably outweigh effects. Finally, careful risk/benefit assessment should undertaken used caution factors.