The New England journal of medicine
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Randomized Controlled Trial Multicenter Study Clinical Trial
Complications of the COX-2 inhibitors parecoxib and valdecoxib after cardiac surgery.
Valdecoxib and its intravenous prodrug parecoxib are used to treat postoperative pain but may involve risk after coronary-artery bypass grafting (CABG). We conducted a randomized trial to assess the safety of these drugs after CABG. ⋯ The use of parecoxib and valdecoxib after CABG was associated with an increased incidence of cardiovascular events, arousing serious concern about the use of these drugs in such circumstances.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Cardiovascular risk associated with celecoxib in a clinical trial for colorectal adenoma prevention.
Selective cyclooxygenase-2 (COX-2) inhibitors have come under scrutiny because of reports suggesting an increased cardiovascular risk associated with their use. Experimental research suggesting that these drugs may contribute to a prothrombotic state provides support for this concern. ⋯ Celecoxib use was associated with a dose-related increase in the composite end point of death from cardiovascular causes, myocardial infarction, stroke, or heart failure. In light of recent reports of cardiovascular harm associated with treatment with other agents in this class, these data provide further evidence that the use of COX-2 inhibitors may increase the risk of serious cardiovascular events.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial.
Selective inhibition of cyclooxygenase-2 (COX-2) may be associated with an increased risk of thrombotic events, but only limited long-term data have been available for analysis. We report on the cardiovascular outcomes associated with the use of the selective COX-2 inhibitor rofecoxib in a long-term, multicenter, randomized, placebo-controlled, double-blind trial designed to determine the effect of three years of treatment with rofecoxib on the risk of recurrent neoplastic polyps of the large bowel in patients with a history of colorectal adenomas. ⋯ Among patients with a history of colorectal adenomas, the use of rofecoxib was associated with an increased cardiovascular risk.