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COX-2 inhibitor could be safest anti-inflammatory drug for older people (p 1751)
May 26, 2004A Canadian study involving over 130,000 older people in this week's issue of THE LANCET shows how the anti-inflammatory cyclo-oxygenase-2 (COX-2) inhibitor celecoxib may have a lower risk of congestive heart failure compared with other non-steroidal anti-inflammatory drugs.
Non-selective, non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used by older people to relieve arthritis symptoms, but are associated with an increased risk of congestive heart failure. Less is known about the cardiovascular effects of COX-2 inhibitors, a newer group of NSAIDS.
Muhammad Mamdani from the Institute for Clinical Evaluative Sciences (ICES), Toronto, Canada, and colleagues assessed retrospectively the risk of hospital admission for heart failure for around 14,500 people using the COX-2 inhibitor rofecoxib, around 19,000 using the COX-2 inhibitor celecoxib, and around 5400 people who had been using non-selective NSAIDs. 100,000 people not using NSAIDs were used as a control group.
Compared with non-NSAID users, patients on rofecoxib had an 80% increase in hospital admission for heart failure; people using non-selective NSAIDS had a 40% increased admission risk. However, users of celecoxib had the same rate of hospital admission for heart failure as people who had never used NSAIDs.
Dr Mamdani comments: "our findings suggest significant differences between non-selective NSAIDs and individual COX-2 inhibitors with respect to risk of admission for congestive heart failure. The clinical relevance of these findings, in view of the widespread use of the drugs, warrants the implementation of large-scale randomised controlled trials to examine this issue further."
Lancet
Heart Failure Current Events and Heart Failure News RSSNew hope for cancer comes straight from the heart
Digitalis-based drugs like digoxin have been used for centuries to treat patients with irregular heart rhythms and heart failure and are still in use today. In the Dec. 16 issue of the Proceedings of the National Academy of Sciences, researchers at the Johns Hopkins University School of Medicine now report that this same class of drugs may hold new promise as a treatment for cancer.
New appropriate use criteria guide treatment of patients with heart blockage
If you're committed to fitness, the decision to climb a couple of flights of stairs rather than take the elevator is clear. But if you develop chest pain on the way up, deciding how to treat the symptoms of clogged arteries in your heart is much more complicated.
Arousal frequency in heart failure found to be a unique sleep problem
A study in the Jan. 1 issue of the journal Sleep demonstrates that the frequent arousals from sleep that occur in heart failure patients with central sleep apnea (CSA) may reflect the presence of another underlying arousal disorder rather than being a defensive mechanism to terminate apneas.
Simple Model Predicts Those at Risk for Chronic Kidney Disease
Traditionally, doctors have had no clear way to predict which of their patients might be headed down the road to chronic kidney disease (CKD).
Implantable monitor may help in managing diastolic heart failure
An implantable hemodynamic monitor (IHM) may help to guide medical treatment in a large subgroup of patients with heart failure-those with diastolic heart failure (DHF).
Study finds treatment fails to improve common form of heart failure
A medication used for high blood pressure does not improve a common form of heart failure, according to new results from a large, international study.
Vitamin E shows possible promise in easing chronic inflammation
With up to half of a person's body mass consisting of skeletal muscle, chronic inflammation of those muscles - which include those found in the limbs - can result in significant physical impairment.
Fruit fly research may lead to better understanding of human heart disease
Researchers at the Burnham Institute for Medical Research (Burnham) have shown in both fruit flies and humans that genes involved in embryonic heart development are also integral to adult heart function. The study, led by Rolf Bodmer, Ph.D., was published in Proceedings of National Academy of Sciences.
Mini heart attacks lessen damage from major ones
Researchers have discovered one potential mechanism by which briefly cutting off, then restoring, blood flow to arteries prior to a heart attack lessens the damage caused, according to a study published today in the journal Cardiovascular Research.
Mechanisms of cardiovascular disease and cancer give clues to new therapies
Cardiovascular conditions leading to heart attacks and strokes are treated quite separately from common cancers of the prostate, breast or lung, but now turn out to involve some of the same critical mechanisms at the molecular level.
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