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Review

Cyclo-Oxygenase (COX) Inhibitors and Cardiovascular Risk: Are Non-Steroidal Anti-Inflammatory Drugs Really Anti-Inflammatory?

1
Department of Pharmacology, Monash University, Clayton, Victoria 3800, Australia
2
Baker IDI Heart and Diabetes Institute, Melbourne, Victoria 3004, Australia
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(17), 4262; https://doi.org/10.3390/ijms20174262
Received: 30 July 2019 / Accepted: 8 August 2019 / Published: 30 August 2019
(This article belongs to the Special Issue Endothelial Dysfunction: Pathophysiology and Molecular Mechanisms)
Cyclo-oxygenase (COX) inhibitors are among the most commonly used drugs in the western world for their anti-inflammatory and analgesic effects. However, they are also well-known to increase the risk of coronary events. This area is of renewed significance given alarming new evidence suggesting this effect can occur even with acute usage. This contrasts with the well-established usage of aspirin as a mainstay for cardiovascular prophylaxis, as well as overwhelming evidence that COX inhibition induces vasodilation and is protective for vascular function. Here, we present an updated review of the preclinical and clinical literature regarding the cardiotoxicity of COX inhibitors. While studies to date have focussed on the role of COX in influencing renal and vascular function, we suggest an interaction between prostanoids and T cells may be a novel factor, mediating elevated cardiovascular disease risk with NSAID use. View Full-Text
Keywords: cyclo-oxygenase; prostanoids; T cells; immune-mediated hypertension; adaptive immunity; vascular dysfunction; coronary disease cyclo-oxygenase; prostanoids; T cells; immune-mediated hypertension; adaptive immunity; vascular dysfunction; coronary disease
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MDPI and ACS Style

Khan, S.; Andrews, K.L.; Chin-Dusting, J.P.F. Cyclo-Oxygenase (COX) Inhibitors and Cardiovascular Risk: Are Non-Steroidal Anti-Inflammatory Drugs Really Anti-Inflammatory? Int. J. Mol. Sci. 2019, 20, 4262. https://doi.org/10.3390/ijms20174262

AMA Style

Khan S, Andrews KL, Chin-Dusting JPF. Cyclo-Oxygenase (COX) Inhibitors and Cardiovascular Risk: Are Non-Steroidal Anti-Inflammatory Drugs Really Anti-Inflammatory? International Journal of Molecular Sciences. 2019; 20(17):4262. https://doi.org/10.3390/ijms20174262

Chicago/Turabian Style

Khan, Shanzana, Karen L. Andrews, and Jaye P.F. Chin-Dusting 2019. "Cyclo-Oxygenase (COX) Inhibitors and Cardiovascular Risk: Are Non-Steroidal Anti-Inflammatory Drugs Really Anti-Inflammatory?" International Journal of Molecular Sciences 20, no. 17: 4262. https://doi.org/10.3390/ijms20174262

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