Impact of prolonged cyclooxygenase-2 inhibition on inflammatory markers and endothelial function in patients with ischemic heart disease and raised C-reactive protein: A randomized placebo-controlled study

Divergent effects of rofecoxib on endothelial function and inflammation in acute coronary syndromes

“…The reduction of IL-6 levels is in agreement with the reduction of the acute phase inflammatory marker CRP and could imply an anti-inflammatory action of rofecoxib. Our short-term results are in accordance with those presented by Monakier et al [8] and Bogaty et al [5] who found a significant reduction of inflammatory markers after 1, 3 and 6 months of rofecoxib treatment.…”

“…Similar or even lower sample size has also been found to be sufficiently powered to detect significant treatment effects on endothelial function and CRP in previous studies as well [5,6,13].…”

“…The effects of COX-2 inhibitors on endothelial function have been studied in healthy volunteers [27], in patients with stable coronary artery disease [4,7] and acute coronary syndromes [5,8] as well as in patients with essential hypertension [6,9].…”

“…Clinical studies examining the effects of COX-2 inhibitors on endothelial function in patients with cardiovascular diseases have shown differential results [4][5][6][7][8][9]. The aim of this study was to examine the short-term effects of the selective COX-2 inhibitor, rofecoxib, in markers for cardiovascular disease, namely endothelial function, a marker of risk in patients with atherosclerotic heart disease, malondialdehyde, a marker of lipid peroxidation, C-reactive protein, a sensitive marker of inflammation and interleukin-6, a proinflammatory cytokine, in patients with acute coronary syndromes without ST-segment elevation.…”

Long-term Risk of Ischemic Stroke Associated with Rofecoxib

“…First, rofecoxib has been shown to accelerate atherogenesis in mouse models by inhibiting PGI 2 and uncoupling of oxidative phosphorylation [15]. Second, rofecoxib use lowers inflammatory markers such as C-reactive protein and interleukin-6 and discontinuation of rofecoxib causes a rebound increase in these markers after 1-3 months [16]. Lastly, patients and investigators were unblinded at the end of the study, possibly leading to a bias in ascertainment of outcomes.…”