Non-steroidal anti-inflammatory drugs and cardiovascular risk
The distinction between traditional NSAIDs and coxibs makes no sense, given that some of the first possess a similar COX-2 selectivity as the latter. The coxibs are associated with greater cardiovascular risk, and thus should not be employed in patients with a high cardiovascular risk. Ibuprofen in doses of up to 1,200 mg daily and naproxen are the anti-inflammatory agents with the most available information on safety with regard to cardiovascular risk. Diclofenac seems to carry a greater risk. The use of safer agents should be considered, and the NSAIDs should be employed in low doses and for the shortest period possible. The use of NSAIDs in patients with heart failure and those under treatment with aspirin should be avoided as far as possible.
- Javier Garjón et al. Drug Information Unit. Navarre Regional Health Service. Spain.