Cardiovascular journal of Africa
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Review Comparative Study
Review of the cardiovascular safety of COXIBs compared to NSAIDS.
There is no doubt that NSAIDs and COXIBS are the mainstay for managing pain and inflammation in arthritis. Overall, at therapeutically equivalent doses, both NSAIDs and COXIBs provide equivalent analgesic and anti-inflammatory efficacy. However, the gastrointestinal risk associated with NSAIDs is considerable. ⋯ One needs to take into account the underlying baseline cardiovascular risk of the populations being compared. COXIBs appear to be prescribed preferentially to patients who were at an increased risk of cardiovascular events compared with patients prescribed non-specific NSAIDs. When the overall risk of cardiovascular complications is relatively low and an anti-inflammatory agent is required, current evidence suggests that celecoxib is an agent of choice because of its lower cardiovascular toxicity potential compared to NSAIDs and other COXIBs.
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Case Reports
Takotsubo cardiomyopathy: an acute and reversible cardiomyopathy mimicking acute myocardial infarction.
Takotsubo cardiomyopathy is an acute, reversible form of left ventricular dysfunction precipitated by emotional or physical stress. The condition is important to recognise as it mimics acute myocardial infarction and acute coronary syndrome. Most patients are female and postmenopausal. ⋯ The most effective long-term management remains to be defined. Although the prognosis is good with recovery of ventricular function at about three weeks, some patients have died. The syndrome may recur.