Cardiovascular issues associated with selective COX2 inhibitors
NSAIDs and coxibs do not provide the same protective effects as low-dose aspirin. Coxibs (selective COX2 inhibitors) decrease vascular prostacyclin (PGI2) production and may affect the balance between prothrombotic and antithrombotic eicosanoids. However, the available studies can suggest only that there is a potential increase in cardiovascular events compared to the traditional NSAIDs. In patients taking a coxib agent, the recommendation is to maintain low-dose daily aspirin in patients who are at significant risk of a cardiovascular event. However, the use of low-dose acetyl salicylic acid (ASA) does not consistently negate the potential cardiovascular risk of COX2 inhibitors.