Mitigating the Cardiovascular and Renal Effects of NSAIDs

摘要

Objective. Nonsteroidal anti-inflammatory drugs (NSAIDs) are principal pharmacologic agents for symptom relief in patients with arthritis and other inflammatory conditions. Cardiovascular risk is associated with all NSAIDs, excluding aspirin. Selective inhibition of cyclo-oxygenase-2 (C0X)-2 could produce a relative reduction in endothelial production of prostacyclin, while leaving the platelet production of thromboxane A2 (TXA2) intact. It has been speculated that this imbalance of homeostatic prostanoids might increase the risk for thrombotic events.The goal of this review is to provide physicians guidelines to mitigate cardiovascular and nephro-toxicity of NSAIDs.Methods. We conducted a systematic literature review to determine what information is available to guide treatment decisions in this patient population.