The Risk for Myocardial Infarction with Cyclooxygenase-2 Inhibitors
Authors: James M. Brophy, Linda E. Lévesque, Bin Zhang
Journal: Annals of Internal Medicine (2005)

Letters18 October 2005The Risk for Myocardial Infarction with Cyclooxygenase-2 InhibitorsJames M. Brophy, MD, PhD, Linda E. Lévesque, BScPhm, MSc, and Bin Zhang, MScJames M. Brophy, MD, PhDFrom McGill University, Montréal, Québec H3A 1A1, Canada.Search for more papers by this author, Linda E. Lévesque, BScPhm, MScFrom McGill University, Montréal, Québec H3A 1A1, Canada.Search for more papers by this author, and Bin Zhang, MScFrom McGill University, Montréal, Québec H3A 1A1, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-8-200510180-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Kim and colleagues that, while celecoxib appears to be less cardiotoxic than rofecoxib in several observational studies (1-3), there is nevertheless reason for concern—particularly when the drug is given in higher doses (as in the APC trial) or in the largely unstudied group of patients with previous myocardial infarctions. We also agree that any cardioprotective benefits of aspirin in rofecoxib users may be offset by a significant reduction in gastrointestinal protection.As Pijak and colleagues point out, the exact cardioprotective mechanism of aspirin and its potential interaction with COX-2 inhibitors is far from established and ...References1. Graham DJ, Campen D, Hui R, Spence M, Cheetham C, Levy G, et al. Risk of acute myocardial infarction and sudden cardiac death in patients treated with cyclo-oxygenase 2 selective and non-selective non-steroidal anti-inflammatory drugs: nested case–control study. Lancet. 2005;365:475-81. [PMID: 15705456] CrossrefMedlineGoogle Scholar2. Solomon DH, Schneeweiss S, Glynn RJ, Kiyota Y, Levin R, Mogun H, et al. Relationship between selective cyclooxygenase-2 inhibitors and acute myocardial infarction in older adults. Circulation. 2004;109:2068-73. [PMID: 15096449] CrossrefMedlineGoogle Scholar3. Ray WA, Stein CM, Hall K, Daugherty JR, Griffin MR. Non-steroidal anti-inflammatory drugs and risk of serious coronary heart disease: an observational cohort study. Lancet. 2002;359:118-23. [PMID: 11809254] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From McGill University, Montréal, Québec H3A 1A1, Canada.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Risk for Myocardial Infarction with Cyclooxygenase-2 Inhibitors: A Population Study of Elderly Adults Linda E. Lévesque , James M. Brophy , and Bin Zhang The Risk for Myocardial Infarction with Cyclooxygenase-2 Inhibitors Jeong A. Kim , Youn Seon Choi , Dokyung Yoon , and Kyung Hwan Cho The Risk for Myocardial Infarction with Cyclooxygenase-2 Inhibitors Michal R. Pijak , Igor Huzicka , and Frantisek Gazdik The Risk for Myocardial Infarction with Cyclooxygenase-2 Inhibitors Ken Shinmura and Roberto Bolli Metrics Cited byCurrent awareness: Pharmacoepidemiology and drug safety 18 October 2005Volume 143, Issue 8Page: 617-618KeywordsConflicts of interestDrugsInflammationMyocardial infarctionObservational studies ePublished: 18 October 2005 Issue Published: 18 October 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...