Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 52, Issue 20, Pages 1637-1639Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2008.08.042
Keywords
nonsteroidal anti-inflammatory drugs; cyclooxygenase; prostacyclin; thromboxane; cardiovascular risk; myocardial infarction
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Selectivity toward cyclooxygenase ( COX)-2 is usually defined by comparing the capacity of individual nonsteroidal anti-inflammatory drugs ( NSAIDs) to inhibit in vitro or ex vivo the generation of thromboxane A(2) (TXA(2)) through COX-1 in aggregating platelets with the capacity to inhibit prostaglandin ( PG) E-2 generation through COX-2, expressed in leukocytes after an inflammatory stimulus ( 1). This rather simple test has been regarded as the most useful tool to define a priori the gastric tolerability and potential anti-inflammatory capacity of new NSAIDs, but has turned out to be a criterion to identify potential cardiovascular damage associated with the use of selective or nonselective COX-2 inhibitors and to interpret the results of clinical trials.
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