Aspirin Research Today is a free monthly online journal that collates and summarizes the latest research about Aspirin, including details on acetylsalicylic acid, baby aspirin, side effects, overdose, allergy.

The cardiovascular toxicity of selective and nonselective cyclooxygenase inhibitors: comparisons, contrasts, and aspirin confounding.

Konstantinopoulos PA, Lehmann DF

SUNY Upstate Medical University, Syracuse, NY 13210, USA.

The premature suspension of the Alzheimer Disease Anti-inflammatory Prevention (ADAPT) and the Adenoma Prevention with Celecoxib (APC) trials prompted intense review of the cardiovascular safety profile of selective and nonselective cyclooxygenase (COX) inhibitors. This article reviews the current state of selective COX-2 inhibitors, discusses the mechanistic evidence underlying the cardiovascular risk associated with selective COX-2 inhibition, outlines the pharmacodynamics of aspirin effects on platelets and the interference of propionic acid derivatives (ibuprofen and naproxen) with these effects, and poses that aspirin confounding may have led to the erroneous conclusion of naproxen-associated adverse cardiovascular outcomes in the ADAPT trial. Finally, recommendations regarding selective COX-2 inhibitors and appropriate timing of aspirin coadministration with traditional NSAIDs are proposed in relevance to patient safety and future trial design.

Published 13 June 2005 in J Clin Pharmacol, 45(7): 742-50.
Full-text of this article is available online (may require subscription).

© 2004-2008 Aspirin Research Today. All Rights Reserved.