COX-2 inhibitors and cardiovascular risk

Non-steroidal anti-inflammatory drugs (NSAIDs) have potentially dangerous side effects, which has led to intense interest in the development of the cyclo-oxygenase (COX) inhibitors. This article reviews the science, safety and clinical evidence to date with these drugs.
They appear to have fewer gastrointestinal and equivalent renal risks to NSAIDs. Reviewing the clinical evidence, particularly the complex cardiovascular effects of the COX inhibitors, the article discusses the clinical relevance of their thrombogenic and anti-atherosclerotic potential. Since many of the studies are retrospective analyses, randomised clinical trials are needed to ascertain whether these cardiovascular effects constitute a problem or an unexpected benefit, and whether there are differences between the different COX-2 inhibitors.