Adverse Cardiovascular Events with Nonsteroidal Anti-inflammatory Agents

Antonis S Manolis


The extensive use of nonsteroidal anti-inflammatory drugs (NSAIDs), both nonselective and cyclooxygenase- 2–specific inhibitors, for the relief of acute and chronic musculoskeletal pain, in addition to gastrointestinal toxicity, confers serious cardiovascular toxicity that affects the overall risk/benefit ratio of this commonly employed therapy. A plethora of studies have provided convincing evidence for a high risk of adverse cardiovascular events associated with NSAIDs related to a number of risk factors, which are herein briefly reviewed and an algorithm is suggested for their safer use.


nonsteroidal anti-inflammatory drugs; coxibs; osteoarthritis; rheumatoid arthritis; cardiovascular disease; hypertension; myocardial infarction; heart failure

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