Vardeny Orly, Solomon Scott D
School of Pharmacy, University of Wisconsin, 777 Highland Avenue, Madison, WI 53705-2222, USA.
Cardiol Clin. 2008 Nov;26(4):589-601. doi: 10.1016/j.ccl.2008.06.004.
Cyclooxygenase-2 (cox-2) inhibitors, also known as coxibs, were introduced with the promise that they would provide pain relief similar to that of traditional nonsteroidal anti-inflammatory drugs (NSAIDs) but would be better tolerated with lower risk of gastrointestinal (GI) side effects. Although coxibs were associated with lower GI risk, experimental and observational data raised the specter of increased cardiovascular risk associated with this class of drugs. This article describes the pharmacologic and biologic basis of cardiovascular risk associated with coxibs, summarizes the evidence for cardiovascular risk associated with cox-2 inhibitors, and weighs the risks and potential benefits of pain management with these agents.
环氧化酶-2（COX-2）抑制剂，也称为昔布类药物，在引入时曾被寄予厚望，即它们能提供与传统非甾体抗炎药（NSAIDs）相似的止痛效果，但耐受性更好，胃肠道（GI）副作用风险更低。尽管昔布类药物与较低的胃肠道风险相关，但实验和观察数据引发了这类药物会增加心血管风险的担忧。本文描述了与昔布类药物相关的心血管风险的药理和生物学基础，总结了与COX-2抑制剂相关的心血管风险证据，并权衡了使用这些药物进行疼痛管理的风险和潜在益处。
