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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >The cardiovascular toxicity of selective and nonselective cyclooxygenase inhibitors: comparisons, contrasts, and aspirin confounding.
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The cardiovascular toxicity of selective and nonselective cyclooxygenase inhibitors: comparisons, contrasts, and aspirin confounding.

机译：选择性和非选择性环氧合酶抑制剂的心血管毒性：比较，对比和阿司匹林混淆。

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摘要

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.
机译：阿尔茨海默病抗炎预防（ADAPT）和塞来昔布预防腺瘤（APC）试验的过早停用，促使人们强烈审查选择性和非选择性环氧合酶（COX）抑制剂的心血管安全性。本文回顾了选择性COX-2抑制剂的现状，讨论了与选择性COX-2抑制相关的心血管风险的机制证据，概述了阿司匹林对血小板的药效学和丙酸衍生物（布洛芬和萘普生）的干扰这些影响，并提出阿司匹林混淆可能导致在ADAPT试验中错误地得出了萘普生相关的不良心血管预后。最后，针对患者安全和未来的试验设计，提出了有关选择性COX-2抑制剂以及阿司匹林与传统NSAID共同给药的适当时机的建议。

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