/publications/issue/2004/2004-12/2004-12-4826

Class of Drugs May Raise Risk of Heart Attack

Author: Susan Farley

Following the revelation that the arthritis drug Vioxx (rofecoxib) may increase its users' risk for heart attack, researchers are finding that the entire cyclooxygenase-2 class of drugs may produce the same adverse effect as Vioxx. The results of previous studies of Celebrex (celecoxib) and Vioxx suggest that the mechanism of action that inhibits inflammation and makes the drug easier on the stomach also may block a certain substance that helps prevent heart problems. Garret FitzGerald, MD, a cardiologist at the University of Pennsylvania who led the present study, believes that the effect is present throughout the entire class of drugs.

In studies published in 1999 and 2001, Dr. FitzGerald and colleagues suggested that, by blocking prostaglandins that lead to inflammation, they were creating heart problems while trying to ease stomach problems. Dr. FitzGerald explained, "There's a good prostaglandin and a bad prostaglandin, as far as the heart is concerned." He said that the suppressing of both types of prostaglandins, in the way that nonsteroidal anti-inflammatory drugs do, actually helps the heart, whereas shutting down only the "good" prostaglandin can raise the risk of high blood pressure, atherosclerosis, and clotting.