Stroke

Further evidence suggesting harm of cyclooxygenase-2 (COX-2) inhibitors in patients with stroke has been reported, with this latest study showing these agents to be associated with an increased risk for stroke mortality.

A recent study published in Neurology. "We found 30-day mortality from stroke increased by around 20% if patients were taking a COX-2 inhibitor before admission," coauthor Christian Christiansen, PhD, commented." No such effect was seen with regular NSAIDs [nonsteroidal anti-inflammatory drugs]."

COX-2 selective inhibitor is a form of non-steroidal anti-inflammatory drug (NSAID) that directly targets COX-2, an enzyme responsible for inflammation and pain.

"This is more evidence that COX-2 inhibitors are harmful to patients at risk of cardiovascular events and stroke. Previous studies have shown these drugs are associated with a higher risk of having a cardiovascular event or a stroke and now we have shown that they are also associated with a higher rate of mortality in stroke patients."

"Our results just emphasize the need for caution in using COX-2 inhibitors in patients with any risk factors for stroke," Dr Christiansen noted. "The latest recommendations already advise against use of these drugs and regular NSAIDs in patients with cardiovascular or stroke risk factors.

On the possible mechanism behind this effect, Dr Christiansen suggested that this could involve suppression of the neuroprotective effect of prostaglandin E2. Alternatively, COX-2 inhibitors may cause larger strokes to occur or increase the risk for stroke as a complication of myocardial infarction.

The authors conclude that their study "adds to the increasing body of evidence concerning the vascular risk and prognostic impact associated with use of COX-2 inhibitors," noting that use of diclofenac has previously been reported to more than double the risk for ischemic stroke.

Rofecoxib (commonly known as Vioxx) was taken off the market in 2004 because of significant increase in heart attacks and strokes. 

Family First Chiropractic is accepting new patients. We are located at 142 Erickson Dr, Red Deer AB. 403-347-3261.

www.family1stchiro.ca