The Risk for Myocardial Infarction with Cyclooxygenase-2 Inhibitors
Authors: Ken Shinmura, Roberto Bolli
Journal: Annals of Internal Medicine (2005)

Letters18 October 2005The Risk for Myocardial Infarction with Cyclooxygenase-2 InhibitorsKen Shinmura, MD, PhD and Roberto Bolli, MDKen Shinmura, MD, PhDFrom Keio University School of Medicine, Tokyo, Japan, and Institute of Molecular Cardiology, University of Louisville, Louisville, KY 40292.Search for more papers by this author and Roberto Bolli, MDFrom Keio University School of Medicine, Tokyo, Japan, and Institute of Molecular Cardiology, University of Louisville, Louisville, KY 40292.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-8-200510180-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The reason for the propensity of COX-2 inhibitors to facilitate cardiovascular events remains unclear. A commonly postulated mechanism is an imbalance between prostacyclin (antithrombotic activity) and thromboxane (prothrombotic activity) because prostacyclin production depends on COX-2 activity in humans (1). However, Lévesque and colleagues (2) reported that low-dose aspirin mitigates cardiovascular risk in elderly patients taking rofecoxib in low doses but not in those taking high doses. Similarly, Nussmeier and colleagues (3) demonstrated that the use of parecoxib and valdecoxib after coronary artery bypass grafting was associated with increased cardiovascular events despite coadministration of low-dose aspirin. Coadministration of ...References1. McAdam BF, Catella-Lawson F, Mardini IA, Kapoor S, Lawson JA, FitzGerald GA. Systemic biosynthesis of prostacyclin by cyclooxygenase (COX)-2: the human pharmacology of a selective inhibitor of COX-2. Proc Natl Acad Sci U S A. 1999;96:272-7. [PMID: 9874808] CrossrefMedlineGoogle Scholar2. Lévesque LE, Brophy JM, Zhang B. The risk for myocardial infarction with cyclooxygenase-2 inhibitors: a population study of elderly adults. Ann Intern Med. 2005;142:481-9. [PMID: 15809459] LinkGoogle Scholar3. Nussmeier NA, Whelton AA, Brown MT, Langford RM, Hoeft A, Parlow JL, et al. Complications of the COX-2 inhibitors parecoxib and valdecoxib after cardiac surgery. N Engl J Med. 2005;352:1081-91. [PMID: 15713945] CrossrefMedlineGoogle Scholar4. Yellon DM, Downey JM. Preconditioning the myocardium: from cellular physiology to clinical cardiology. Physiol Rev. 2003;83:1113-51. [PMID: 14506302] CrossrefMedlineGoogle Scholar5. Shinmura K, Tang XL, Wang Y, Xuan YT, Liu SQ, Takano H, et al. Cyclooxygenase-2 mediates the cardioprotective effects of the late phase of ischemic preconditioning in conscious rabbits. Proc Natl Acad Sci U S A. 2000;97:10197-202. [PMID: 10963682] CrossrefMedlineGoogle Scholar6. Bolli R, Shinmura K, Tang XL, Kodani E, Xuan YT, Guo Y, et al. Discovery of a new function of cyclooxygenase (COX)-2: COX-2 is a cardioprotective protein that alleviates ischemia/reperfusion injury and mediates the late phase of preconditioning. Cardiovasc Res. 2002;55:506-19. [PMID: 12160947] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Ken Shinmura, MD, PhD; Roberto Bolli, MDAffiliations: From Keio University School of Medicine, Tokyo, Japan, and Institute of Molecular Cardiology, University of Louisville, Louisville, KY 40292.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 James M. Brophy , Linda E. Lévesque , 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 Metrics Cited byOccult Cardiotoxicity—Toxic Effects on Cardiac Ischemic ToleranceThe late phase of preconditioning and its natural clinical application—gene therapyCurrent awareness: Pharmacoepidemiology and drug safety 18 October 2005Volume 143, Issue 8Page: 617KeywordsDrugsHeartIschemiaMyocardiumProstacyclinProstaglandinProstaglandinsThromboxane ePublished: 18 October 2005 Issue Published: 18 October 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...