Study of Cardiovascular Toxicity of Selective COX-2 Inhibitors In Comparison With Conventional NSAIDs

Abstract

Introduction: Non-steroidal anti-inflammatory drugs presently are the most widely used over the counter drugs in medicine and the most frequent cause of adverse drug reactions, affecting even the cardiovascular system, which is a major and alarming public health concern. Previous studies report, that selective COX-2 inhibitors are safer when compared to non-selective cyclooxygenase inhibitors, regarding their cardiovascular toxicity. But, recent studies reveal, that the safety of these selective COX-2 inhibitors is not much better than that of conventional NSAIDs. In view of the wider usage of selective COX-2 inhibitors, the study has been taken up to report, whether selective COX-2 inhibitors have got any advantages over conventional NSAIDs or not, regarding their effect on the basic parameters of cardiovascular system bleeding time, clotting time, heart rate, blood pressure and ECG.

Methods: Patients were divided into eight groups, fifteen patients of each. Each group was given one of the NSAIDs from the eight drugs those were selected for the study, for 15 days. In the selected group, both pre and post-treatment values of bleeding time, clotting time, heart rate and blood pressure are estimated, tabulated and subjected to statistical analysis. ECG readings were also taken both before and after treatment and analyzed.

Results: Non-selective NSAIDs like paracetamol and diclofenac have shown significant changes in their bleeding time. Preferential COX-2 inhibitors like nimesulide and meloxicam; selective COX-2 inhibitors like celecoxib and valdecoxib also have shown significant changes in their bleeding time. There is no significant change in clotting time, heart rate, systolic and diastolic blood pressure and also ECG.

Conclusion: Selective COX-2 inhibitors also have shown significant changes in bleeding time, like that of non-selective NSAIDs, when used for a short-term treatment.