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December 1, 2007Anesthesia & Analgesia

Cardiovascular Thromboembolic Adverse Effects Associated with Cyclooxygenase-2 Selective Inhibitors and Nonselective Antiinflammatory Drugs

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Why the study?

Do COX-2 selective inhibitors and nonselective NSAIDs increase the risk of cardiovascular thromboembolic adverse effects?

Population

Patients using nonsteroidal antiinflammatory drugs, including both cyclooxygenase-2 selective inhibitors and…

Comparison

Cyclooxygenase-2 selective inhibitors and… vs Placebo or active comparators

Design

Review

Authors

GJGirish P. JoshiNorthwestern UniversityRGRalph GertlerLudwig-Maximilians-Universität MünchenRFRuth FrickerPfizer (United States)

Discussion

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Implication

Supports careful NSAID risk-benefit assessment in high-risk patients; confirms agent-specific CV risks but leaves optimal selection open.

Structured PICO

Do COX-2 selective inhibitors and nonselective NSAIDs increase the risk of cardiovascular thromboembolic adverse effects?

P
Population
Patients using nonsteroidal antiinflammatory drugs (NSAIDs), including both cyclooxygenase (COX)-2 selective inhibitors and nonselective NSAIDs, particularly those at high cardiovascular risk
I
Intervention
Cyclooxygenase (COX)-2 selective inhibitors and nonselective NSAIDs (long-term and short-term use)
C
Comparator
Placebo or active comparators (as evaluated in the reviewed literature)
O
Outcome
Cardiovascular thromboembolic adverse effectssafety

Both COX-2 selective inhibitors and nonselective NSAIDs are associated with increased cardiovascular thromboembolic risks, especially in high-risk patients, necessitating careful risk/benefit assessment prior to use.

Limitations

  • Studies evaluating the CV risks have limitations
  • Lack of long-term, prospective, randomized, adequately powered clinical studies in relevant patient populations

Cite This Study

Joshi et al. (2007) studied this question.

synapsesocial.com/papers/6a8bb0b890fae8fd47e98a9dhttps://doi.org/10.1213/01.ane.0000286229.05723.50
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Also Consider

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