Michal R. Pijak, MD; Igor Huzicka, MD; Frantisek Gazdik, MD, PhD
Potential Financial Conflicts of Interest: Consultancies: M.R. Pijak (Pfizer, Inc., Merck Sharpe & Dohme, Fournier Slovakia); Honoraria: M.R. Pijak (Pfizer, Inc., Merck Sharpe & Dohme, Fournier Slovakia).
Pijak M., Huzicka I., Gazdik F.; The Risk for Myocardial Infarction with Cyclooxygenase-2 Inhibitors. Ann Intern Med. 2005;143:616-617. doi: 10.7326/0003-4819-143-8-200510180-00021
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Published: Ann Intern Med. 2005;143(8):616-617.
TO THE EDITOR:
The population-based cohort study by Lévesque and colleagues (1) has shown that aspirin eliminated the excess risk for myocardial infarction in persons receiving low doses of rofecoxib. This finding further supports the hypothesis that aspirin might mitigate the cardiovascular risk associated with the use of selective COX-2 inhibitors (2). The authors, however, fail to explain why this risk-modifying effect of aspirin was not seen with higher doses of rofecoxib and why no increase in risk was observed with celecoxib. Experimental and clinical data suggest that a competitive interaction between these drugs and aspirin on both cyclooxygenase-1 (COX-1) and COX-2 enzymes may play the most important role.
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