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non-steroidal anti-inflammatory drugs an overview of cardiovascular risks非甾体抗炎药心血管疾病风险的概述.pdf

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non-steroidal anti-inflammatory drugs an overview of cardiovascular risks非甾体抗炎药心血管疾病风险的概述

Pharmaceuticals 2010, 3, 2146-2162; doi:10.3390/ph3072146 OPEN ACCESS pharmaceuticals ISSN 1424-8247 /journal/pharmaceuticals Review Non-Steroidal Anti-Inflammatory Drugs: An Overview of Cardiovascular Risks Inger L. Meek, Mart A.F.J. van de Laar and Harald E. Vonkeman * Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente and University of Twente, Ariensplein 1, 7500 KA Enschede, The Netherlands; E-Mails: i.meek@mst.nl (I.L.M.); m.vandeLaar@mst.nl (M.AFJ.L.) * Author to whom correspondence should be addressed; E-Mail: h.vonkeman@mst.nl; Tel.: 0031-53-4872450; Fax: 0031-53-4873106. Received: 17 June 2010; in revised form: 30 June 2010 / Accepted: 1 July 2010 / Published: 7 July 2010 Abstract: While aspirin may offer protection, other non-aspirin non-steroidal anti- inflammatory drugs (NSAIDs) can cause serious cardiovascular side effects and complications. This has led to a general black box warning for cardiovascular adverse events for NSAIDs. This review explores the different mechanisms underlying the protective effects of aspirin, the NSAID associated renovascular effects causing hypertension, edema and heart failure, the cardiovascular effects causing myocardial infarction and stroke, and the possible deleterious interaction between NSAIDs and aspirin. Keywords: NSAIDs; aspirin; cardiovascular events 1. Introduction Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently pres