TY - JOUR
T1 - Use of nonsteroidal antiinflammatory drugs
T2 - An update for clinicians: A scientific statement from the American Heart Association
AU - Antman, Elliott M.
AU - Bennett, Joel S.
AU - Daugherty, Alan
AU - Furberg, Curt
AU - Roberts, Harold
AU - Taubert, Kathryn A.
PY - 2007/3
Y1 - 2007/3
N2 - Current evidence indicates that selective COX-2 inhibitors have important adverse cardiovascular effects that include increased risk for myocardial infarction, stroke, heart failure, and hypertension. The risk for these adverse effects is likely greatest in patients with a prior history of or at high risk for cardiovascular disease. In these patients, use of COX-2 inhibitors for pain relief should be limited to patients for whom there are no appropriate alternatives, and then, only in the lowest dose and for the shortest duration necessary. More long-term data are needed to fully evaluate the extent to which these important adverse cardiovascular effects may be offset by other beneficial effects of these medications. More data are also needed on the cardiovascular safety of conventional NSAIDs. Until such data are available, the use of any COX inhibitor, including over-the-counter NSAIDs, for long periods of time should only be considered in consultation with a physician. The debate about the increased risk of cardiovascular events attributed to the selective COX-2 inhibitors and the nonselective NSAIDs is part of a broader national debate about drug safety. Optimal safety evaluation of drugs requires timely and complete submission of scientific data from the manufacturers, as well as increased funding and authority granted to the FDA by Congress.
AB - Current evidence indicates that selective COX-2 inhibitors have important adverse cardiovascular effects that include increased risk for myocardial infarction, stroke, heart failure, and hypertension. The risk for these adverse effects is likely greatest in patients with a prior history of or at high risk for cardiovascular disease. In these patients, use of COX-2 inhibitors for pain relief should be limited to patients for whom there are no appropriate alternatives, and then, only in the lowest dose and for the shortest duration necessary. More long-term data are needed to fully evaluate the extent to which these important adverse cardiovascular effects may be offset by other beneficial effects of these medications. More data are also needed on the cardiovascular safety of conventional NSAIDs. Until such data are available, the use of any COX inhibitor, including over-the-counter NSAIDs, for long periods of time should only be considered in consultation with a physician. The debate about the increased risk of cardiovascular events attributed to the selective COX-2 inhibitors and the nonselective NSAIDs is part of a broader national debate about drug safety. Optimal safety evaluation of drugs requires timely and complete submission of scientific data from the manufacturers, as well as increased funding and authority granted to the FDA by Congress.
KW - AHA Scientific Statements
KW - Antiinflammatory agents, nonsteroidal
KW - Aspirin
KW - Coxibs
KW - Cyclooxygenase 2 inhibitors
KW - Drugs
KW - Inhibitors
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U2 - 10.1161/CIRCULATIONAHA.106.181424
DO - 10.1161/CIRCULATIONAHA.106.181424
M3 - Review article
C2 - 17325246
AN - SCOPUS:34247464709
SN - 0009-7322
VL - 115
SP - 1634
EP - 1642
JO - Circulation
JF - Circulation
IS - 12
ER -