Hermann Matthias, Ruschitzka Frank
Cardiology, Cardiovascular Center, University Hospital Zürich, Switzerland.
Ann Med. 2007;39(1):18-27. doi: 10.1080/07853890601073445.
Since selective cyclooxygenase-2 inhibitors (coxibs) entered the market, there has been concern about the cardiovascular safety of coxibs. In addition, recent data suggest that classical non-steroidal anti-inflammatory drugs (NSAIDs) have a similar cardiovascular risk. Importantly, all of the clinical trials with NSAIDs and coxibs so far were not purpose-designed to specifically and prospectively address cardiovascular safety and were clearly underpowered to detect any meaningful differences. In this current uncertainty about safety of NSAIDs and coxibs, the definitive answer as to the net effect of coxibs and NSAIDs on cardiovascular events can only be provided by well designed adequately powered, long-term clinical trials, which is now under way.
自选择性环氧化酶-2抑制剂（coxibs）进入市场以来，人们一直关注coxibs的心血管安全性。此外，最近的数据表明，传统非甾体抗炎药（NSAIDs）也有类似的心血管风险。重要的是，迄今为止所有关于NSAIDs和coxibs的临床试验都不是专门为前瞻性地解决心血管安全性而设计的，而且在检测任何有意义的差异方面明显缺乏效力。在目前对NSAIDs和coxibs安全性存在不确定性的情况下，关于coxibs和NSAIDs对心血管事件的净效应的明确答案只能由精心设计、有足够效力的长期临床试验来提供，目前此类试验正在进行中。
