Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-36611
Steffel, J; Luscher, T F; Ruschitzka, F; Tanner, F C (2006). Cyclooxygenase-2 inhibition and coagulation. Journal of Cardiovascular Pharmacology, 47 Sup:S15-20.
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Selective inhibitors of cyclooxygenase-2 (COX-2) have come under scrutiny because of a possibly increased thrombotic risk observed in retrospective studies and comparatively small cancer trials. Indeed, inhibition of COX-2 may favor a prothrombotic environment by suppressing endothelial prostacyclin synthesis while leaving COX-1-dependent platelet thromboxane (TX) A2 synthesis unopposed. However, in vitro studies have shown that the effect of coxibs on coagulation is dependent on several variables; for example, the coxib celecoxib reduces endothelial tissue factor expression, a key initiator of the coagulation cascade. Furthermore, animal studies are inconclusive as some studies investigating the effect of COX-2 inhibition in atherosclerosis imply a detrimental effect of coxibs, whereas others suggest a beneficial effect on plaque progression and stability. In healthy human subjects and in patients with atherosclerotic vascular diseases, the effect of COX-2 inhibition on coagulation is equally unclear as no prospective, randomized, double-blinded studies sufficiently powered to investigate cardiovascular endpoints have been performed to directly investigate a potentially cardiotoxic effect of coxibs. Here, we review the effect of COX-2 inhibition on the coagulation system; we discuss the molecular mechanisms involved and summarize important clinical trials in which an increased frequency of thrombotic complications coxibs was observed.
|Item Type:||Journal Article, refereed, further contribution|
|Communities & Collections:||04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology|
|DDC:||610 Medicine & health|
|Uncontrolled Keywords:||Animals;Blood Coagulation/*drug effects;Cyclooxygenase 2/*metabolism;Cyclooxygenase Inhibitors/*pharmacology;Endothelial Cells/drug effects/enzymology;Humans;Macrophages/drug effects/enzymology;Models, Animal|
|Deposited On:||25 Feb 2011 13:08|
|Last Modified:||02 Dec 2013 00:23|
|Publisher:||Lippincott Wiliams & Wilkins|
|Free access at:||PubMed ID. An embargo period may apply.|
|Citations:||Web of Science®. Times Cited: 7|
Scopus®. Citation Count: 9
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