This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (32)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Cardiovascular Disease/ Myocardial Infarction  • Venous Thromboembolism  • Alert me on articles by topic

Arch Intern Med. 2002;162:1091-1092.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

NONSTEROIDAL ANTI-INFLAMMATORY drugs (NSAIDs) are among the most widely used medications in the world.¹ NSAIDs inhibit cyclooxygenase-1 (COX-1) and COX-2 isoenzymes. Inhibition of COX-1 isoenzymes inhibits the production of thromboxane and thus inhibits platelet aggregation. In addition, inhibition of COX-1 isoenzymes compromises the gastrointestinal mucosa. As a result, the major limitation of NSAIDs is gastrointestinal toxicity, resulting in upper gastrointestinal events in 2% to 4% of patients per year.¹

Selective COX-2 inhibitors do not inhibit COX-1 isoenzymes, and as a result they produce an analgesic and anti-inflammatory effect without gastric toxicity. Since their introduction in 1999, they have become enormously popular, with US sales in the billions of dollars.² Unlike nonselective NSAIDs, COX-2 inhibitors do not inhibit platelet aggregation. As a result, COX-2 inhibitors could adversely affect the hemostatic balance and favor thrombosis.

The concerns that COX-2 inhibitors might predispose to cardiovascular thrombotic events came to center stage with publication . . . [Full Text of this Article]

RELATED ARTICLES

Nonsteroidal Anti-inflammatory Drug Use and Acute Myocardial Infarction
Daniel H. Solomon, Robert J. Glynn, Raisa Levin, and Jerry Avorn
Arch Intern Med. 2002;162(10):1099-1104.
ABSTRACT | FULL TEXT  

Lower Risk of Thromboembolic Cardiovascular Events With Naproxen Among Patients With Rheumatoid Arthritis
Douglas J. Watson, Thomas Rhodes, Bing Cai, and Harry A. Guess
Arch Intern Med. 2002;162(10):1105-1110.
ABSTRACT | FULL TEXT  

Association Between Naproxen Use and Protection Against Acute Myocardial Infarction
Elham Rahme, Louise Pilote, and Jacques LeLorier
Arch Intern Med. 2002;162(10):1111-1115.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Treating Osteoarthritis With Cyclooxygenase-2-Specific Inhibitors: What Are the Benefits of Avoiding Blood Pressure Destabilization?
Grover et al.
Hypertension 2005;45:92-97.
ABSTRACT | FULL TEXT  

Discontinuation of Nonsteroidal Anti-inflammatory Drug Therapy and Risk of Acute Myocardial Infarction
Fischer et al.
Arch Intern Med 2004;164:2472-2476.
ABSTRACT | FULL TEXT  

Nonsteroidal Anti-Inflammatory drugs and cardiovascular risk
Howard and Delafontaine
J Am Coll Cardiol 2004;43:519-525.
ABSTRACT | FULL TEXT  

Gastrointestinal safety of AZD3582, a cyclooxygenase inhibiting nitric oxide donator: proof of concept study in humans
Hawkey et al.
Gut 2003;52:1537-1542.
ABSTRACT | FULL TEXT  

Non-steroidal anti-inflammatory drugs: overall risks and management. Complementary roles for COX-2 inhibitors and proton pump inhibitors
Hawkey and Langman
Gut 2003;52:600-608.
ABSTRACT | FULL TEXT  

Lack of Cardioprotective Effect of Naproxen
Mukherjee et al.
Arch Intern Med 2002;162:2637-2637.
FULL TEXT  

Aspirin Use May Change Cost-effectiveness of COX-2 Inhibitors
Pickard et al.
Arch Intern Med 2002;162:2637-2639.
FULL TEXT