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An Evidence-Based Review of the Cardiovascular Risks of Nonsteroidal Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs), both nonselective and cyclooxygenase-2–specific inhibitors, are commonly used medications for the relief of acute and chronic pain associated with a wide range of medical conditions. Because of the extensive use of these agents, adverse events that occu... Full description

Journal Title: The American journal of cardiology 2009, Vol.103 (9), p.1227-1237
Main Author: Farkouh, Michael E., MD, MSc
Other Authors: Greenberg, Bruce P., PhD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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recordid: cdi_proquest_journals_230373391
title: An Evidence-Based Review of the Cardiovascular Risks of Nonsteroidal Anti-Inflammatory Drugs
format: Article
creator:
  • Farkouh, Michael E., MD, MSc
  • Greenberg, Bruce P., PhD
subjects:
  • Anti-Inflammatory Agents, Non-Steroidal - adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
  • Aspirin
  • Aspirin - adverse effects
  • Aspirin - therapeutic use
  • Atherosclerosis (general aspects, experimental research)
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Bones, joints and connective tissue. Antiinflammatory agents
  • Cardiac patients
  • Cardiology
  • Cardiology. Vascular system
  • Cardiovascular
  • Cardiovascular diseases
  • Cardiovascular Diseases - chemically induced
  • Cardiovascular Diseases - epidemiology
  • Cardiovascular Diseases - physiopathology
  • Care and treatment
  • Cyclooxygenase 2 Inhibitors - adverse effects
  • Cyclooxygenase 2 Inhibitors - therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Drug Interactions
  • Drug therapy
  • Drugs
  • Evidence-Based Medicine
  • Female
  • Humans
  • Incidence
  • Male
  • Medical colleges
  • Medical sciences
  • Meta-analysis
  • Pain
  • Pain - diagnosis
  • Pain - drug therapy
  • Pharmacology
  • Pharmacology. Drug treatments
  • Prescription writing
  • Prognosis
  • Public health
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Risk factors
  • Severity of Illness Index
  • Survival Analysis
  • Time Factors
ispartof: The American journal of cardiology, 2009, Vol.103 (9), p.1227-1237
description: Nonsteroidal anti-inflammatory drugs (NSAIDs), both nonselective and cyclooxygenase-2–specific inhibitors, are commonly used medications for the relief of acute and chronic pain associated with a wide range of medical conditions. Because of the extensive use of these agents, adverse events that occur infrequently may still affect the overall risk/benefit ratio of this class of medications. Serious adverse cardiovascular (CV) events have been reported with NSAID use, but unfortunately, definitive evidence regarding the precise CV risk associated with these drugs, as a class and individually, is lacking. Therefore, it is an issue of public health importance that physicians be guided by careful assessment of the existing evidence to make reasonable choices in prescribing these medications. The investigators review the key clinical trials, meta-analyses of clinical trials, and epidemiologic studies on the subject of the CV safety of NSAIDs and identify key variables that define the CV risk of the NSAIDs. In conclusion, it is important that cardiologists, who are not among those physicians frequently prescribing NSAIDs, have a particular responsibility to have up-to-date, thoughtfully synthesized information about the CV risks of these drugs, especially when administered to patients receiving low-dose aspirin for cardioprotection.
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleAn Evidence-Based Review of the Cardiovascular Risks of Nonsteroidal Anti-Inflammatory Drugs
creatorFarkouh, Michael E., MD, MSc ; Greenberg, Bruce P., PhD
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descriptionNonsteroidal anti-inflammatory drugs (NSAIDs), both nonselective and cyclooxygenase-2–specific inhibitors, are commonly used medications for the relief of acute and chronic pain associated with a wide range of medical conditions. Because of the extensive use of these agents, adverse events that occur infrequently may still affect the overall risk/benefit ratio of this class of medications. Serious adverse cardiovascular (CV) events have been reported with NSAID use, but unfortunately, definitive evidence regarding the precise CV risk associated with these drugs, as a class and individually, is lacking. Therefore, it is an issue of public health importance that physicians be guided by careful assessment of the existing evidence to make reasonable choices in prescribing these medications. The investigators review the key clinical trials, meta-analyses of clinical trials, and epidemiologic studies on the subject of the CV safety of NSAIDs and identify key variables that define the CV risk of the NSAIDs. In conclusion, it is important that cardiologists, who are not among those physicians frequently prescribing NSAIDs, have a particular responsibility to have up-to-date, thoughtfully synthesized information about the CV risks of these drugs, especially when administered to patients receiving low-dose aspirin for cardioprotection.
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languageeng
publisherNew York, NY: Elsevier Inc
subjectAnti-Inflammatory Agents, Non-Steroidal - adverse effects ; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use ; Aspirin ; Aspirin - adverse effects ; Aspirin - therapeutic use ; Atherosclerosis (general aspects, experimental research) ; Biological and medical sciences ; Blood and lymphatic vessels ; Bones, joints and connective tissue. Antiinflammatory agents ; Cardiac patients ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Cardiovascular diseases ; Cardiovascular Diseases - chemically induced ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - physiopathology ; Care and treatment ; Cyclooxygenase 2 Inhibitors - adverse effects ; Cyclooxygenase 2 Inhibitors - therapeutic use ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug Interactions ; Drug therapy ; Drugs ; Evidence-Based Medicine ; Female ; Humans ; Incidence ; Male ; Medical colleges ; Medical sciences ; Meta-analysis ; Pain ; Pain - diagnosis ; Pain - drug therapy ; Pharmacology ; Pharmacology. Drug treatments ; Prescription writing ; Prognosis ; Public health ; Randomized Controlled Trials as Topic ; Risk Assessment ; Risk factors ; Severity of Illness Index ; Survival Analysis ; Time Factors
ispartofThe American journal of cardiology, 2009, Vol.103 (9), p.1227-1237
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descriptionNonsteroidal anti-inflammatory drugs (NSAIDs), both nonselective and cyclooxygenase-2–specific inhibitors, are commonly used medications for the relief of acute and chronic pain associated with a wide range of medical conditions. Because of the extensive use of these agents, adverse events that occur infrequently may still affect the overall risk/benefit ratio of this class of medications. Serious adverse cardiovascular (CV) events have been reported with NSAID use, but unfortunately, definitive evidence regarding the precise CV risk associated with these drugs, as a class and individually, is lacking. Therefore, it is an issue of public health importance that physicians be guided by careful assessment of the existing evidence to make reasonable choices in prescribing these medications. The investigators review the key clinical trials, meta-analyses of clinical trials, and epidemiologic studies on the subject of the CV safety of NSAIDs and identify key variables that define the CV risk of the NSAIDs. In conclusion, it is important that cardiologists, who are not among those physicians frequently prescribing NSAIDs, have a particular responsibility to have up-to-date, thoughtfully synthesized information about the CV risks of these drugs, especially when administered to patients receiving low-dose aspirin for cardioprotection.
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7Blood and lymphatic vessels
8Bones, joints and connective tissue. Antiinflammatory agents
9Cardiac patients
10Cardiology
11Cardiology. Vascular system
12Cardiovascular
13Cardiovascular diseases
14Cardiovascular Diseases - chemically induced
15Cardiovascular Diseases - epidemiology
16Cardiovascular Diseases - physiopathology
17Care and treatment
18Cyclooxygenase 2 Inhibitors - adverse effects
19Cyclooxygenase 2 Inhibitors - therapeutic use
20Dose-Response Relationship, Drug
21Drug Administration Schedule
22Drug Interactions
23Drug therapy
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25Evidence-Based Medicine
26Female
27Humans
28Incidence
29Male
30Medical colleges
31Medical sciences
32Meta-analysis
33Pain
34Pain - diagnosis
35Pain - drug therapy
36Pharmacology
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39Prognosis
40Public health
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42Risk Assessment
43Risk factors
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45Survival Analysis
46Time Factors
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titleAn Evidence-Based Review of the Cardiovascular Risks of Nonsteroidal Anti-Inflammatory Drugs
authorFarkouh, Michael E., MD, MSc ; Greenberg, Bruce P., PhD
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5Atherosclerosis (general aspects, experimental research)
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8Bones, joints and connective tissue. Antiinflammatory agents
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13Cardiovascular diseases
14Cardiovascular Diseases - chemically induced
15Cardiovascular Diseases - epidemiology
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32Meta-analysis
33Pain
34Pain - diagnosis
35Pain - drug therapy
36Pharmacology
37Pharmacology. Drug treatments
38Prescription writing
39Prognosis
40Public health
41Randomized Controlled Trials as Topic
42Risk Assessment
43Risk factors
44Severity of Illness Index
45Survival Analysis
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abstractNonsteroidal anti-inflammatory drugs (NSAIDs), both nonselective and cyclooxygenase-2–specific inhibitors, are commonly used medications for the relief of acute and chronic pain associated with a wide range of medical conditions. Because of the extensive use of these agents, adverse events that occur infrequently may still affect the overall risk/benefit ratio of this class of medications. Serious adverse cardiovascular (CV) events have been reported with NSAID use, but unfortunately, definitive evidence regarding the precise CV risk associated with these drugs, as a class and individually, is lacking. Therefore, it is an issue of public health importance that physicians be guided by careful assessment of the existing evidence to make reasonable choices in prescribing these medications. The investigators review the key clinical trials, meta-analyses of clinical trials, and epidemiologic studies on the subject of the CV safety of NSAIDs and identify key variables that define the CV risk of the NSAIDs. In conclusion, it is important that cardiologists, who are not among those physicians frequently prescribing NSAIDs, have a particular responsibility to have up-to-date, thoughtfully synthesized information about the CV risks of these drugs, especially when administered to patients receiving low-dose aspirin for cardioprotection.
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