Why the study?
Does the administration of nonsteroidal anti-inflammatory drugs and cyclooxygenase 2 inhibitors increase cardiovascular and cerebrovascular risk?
Does the administration of nonsteroidal anti-inflammatory drugs and cyclooxygenase 2 inhibitors increase cardiovascular and cerebrovascular risk?
Long-term, high-dose use of NSAIDs and COX-2 inhibitors increases cardiovascular and thrombotic risk, necessitating careful patient selection and monitoring.
High-dose, long-term NSAID use may raise CV risk; leaves open need for RCTs on COX-2 selectivity effects.
Observational studies and meta-analyses have shown that the administration of nonsteroidal anti-inflammatory drugs (NSAIDs), especially when prescribed at high doses for long periods of time, can potentially increase the risk of cardiovascular diseases. The increased thrombotic risk related to the use of NSAIDs is mainly due to their cyclooxygenase 2 selectivity. The dosage use, the formulation selected and the duration of the therapy are other factors that can significantly impact on the cardiovascular risk. In order to minimize the risk, prescription of the right drug based on the patient's features and the different safety profiles of several NSAIDs that are available on the market is key for their appropriate administration. Despite the baseline cardiovascular and gastrointestinal risk of each patient, monitoring of patients is suggested for increases in blood pressure, development of edema, deterioration of renal function, or gastrointestinal bleeding during long-term treatment with NSAIDs.
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Fanelli et al. (2017) studied this question.
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