Cyclooxygenase-2 (COX-2) inhibiting...

Cyclooxygenase-2 (COX-2) inhibiting medicines were developed to provide the anti-inflammatory events of nonsteroidal anti-inflammatory drugs (NSAIDs) with a reduc risk of gastrointestinal bleeding. transactions have arisen that COX-2 inhibitors could have cardiovascular and renal adverse validitys similar to those of nonselective NSAIDs, of the like kind as raised systemic vascular resistance and decreased renal perfusion. The flow could be an increase in congestive cardiac failure in susceptible patients. Mamdani and colleagues used databases in succession prescription drugs and hospital admissions in a Canadian province to consider for any association between COX-2 inhibitor use and hospital admission for congestive cardiac failure.

From a total population of 13 million living bodys aged 65 years or older the investigators identified patients who were prescribed COX-2 inhibitors (rofecoxib and celecoxib) or nonselective NSAIDs from April 2000 [i]or[/i] part of to the other March 2001. Using the databases for previous prescriptions, they identified 14583 NSAID-naive bodily substances who started rofecoxib therapy and 18908 NSAID-naive someones who started celecoxib therapy. There were 5391 first-time users of nonselective NSAIDs (predominately diclofenac plus misoprostol, naproxen, or ibuprofen). These collections of patients were compared for admission to hospital because of heart failure with 100000 superintend patients who represented the non-NSAID users in the population age group

The sum of two units groups using COX-2 inhibitors were comparable. For example, compared with the NSAID users and check subjects, the patients using COX-2 inhibitors were more likely to be female, to have had echocardiography, and to have received loophole diuretics, digoxin, and several cardiac put drugs intos including beta blockers, calcium channel antagonists, and angiotensin-converting enzyme inhibitors. During the research 654 patients were admitted to a hospital for treatment of congestive heart failure. The rate of admission was significantly increased for those receiving rofecoxib and NSAID compared with the sway group but was not increased for celecoxib users. The risk of hospital admission was significantly increased in those receiving rofecoxib compared with those receiving NSAIDs. The increased risk in those receiving rofecoxib also was noted in the subgroup of patients with no history of a heart-failure-related hospital admission.

The authors close that rofecoxib and nonselective NSAID use is associated with an increased risk of hospital admission for congestive heart failure, however celecoxib use is not. These flows are consistent with studies showing more marked changes in descendants pressure and edema with rofecoxib and could be related to the longer half-life and other pharmacokinetic properties of this mix with drugs They call for further studies to clarify this potentially important efficiency of medications commonly prescribed for somewhat old patients.

Mamdani M et al. Cyclo-oxygenase-2 inhibitors versus non-selective non-steroidal anti-inflammatory physics and congestive heart failure results in elderly patients: a population-based cohort inquiry Lancet May 29, 2004;363:1751-6.

COPYRIGHT 2005 American Academy of Family Physicians

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