The selective COX-2 inhibitors
are known to be associated with an increased risk of death in patients with previous MI.
The study included 23 traditional NSAIDs and four selective COX-2 inhibitors
COX-1 and COX-2 inhibitors
affect enzymes involved with inflammation and other functions in the body.
The results showed that of those currently using a COX-2 inhibitor
, 19% were more likely to die after a stroke than those who didn't take the drug and new users of the medicines had a 42% increase in risk mortality from stroke compared to nonusers.
In so doing, researchers have identified several traditional herbs that contain natural and safe COX-2 inhibitors
After its withdrawal in 2004, following the emergence of evidence of increased cardiovascular morbidity in the APPROVe (Adenomatous Polyp Prevention on Vioxx) study, COX-2 inhibitors
represented less than 16% of the NSAID prescriptions.
Researchers noted the increase in fail-related injuries began in 2004, when the pain killer rofecoxib (Vioxx), a COX-2 inhibitor
widely prescribed for arthritis pain, was taken off the market because of its link to a higher risk of heart attacks and strokes.
Compared with people who did not take the drugs, recent users were about 40% more likely to suffer irregular heart beat if they were on NSAIDs and 70% more likely if they were on COX-2 inhibitors
The researchers found that use of NSAIDs or COX-2 inhibitors
was associated with an increased risk of atrial fibrillation or flutter.
During the period spanned by our data (1999-2002), the two available COX-2 inhibitors
were Vioxx and Celebrex.
Nonsteroidal antiinflammatory drugs (NSAIDs) are divided into two subcategories: (1) COX-2 specific inhibitors (referred to as COX-2 inhibitors
for the remainder of this paper) such as celecoxib (Celebrex[R]), and (2) nonselective NSAIDs (referred to as NSAIDs for the remainder of this paper) such as ibuprofen (Motrin[R]).
The introduction of selective COX-2 inhibitors
in the late 1990s substantially changed the arthritis treatment landscape because of the agents' ability to target the enzyme responsible for inflammation and pain while reducing the risk of NSAID-associated stomach complications, said Dr.
Available data do not allow for adjusted risk assessment for patients with preexisting renal disease on COX-2 inhibitors
(strength of recommendation [SOR]: A, based on meta-analysis).
However, COX-2 inhibitors
have been linked to a heightened risk of heart problems (SN: 10/30/04, p.
500) caution that 'there is now strong evidence to suggest that both the traditional NSAIDs (excluding aspirin) and the COX-2 inhibitors
are associated with an increased risk of thrombotic events (including myocardial infarction and stroke) and excess mortality both in patients with and without pre-existing cardiovascular disease'.