Cyclooxygenase inhibition and adverse remodeling during healing after myocardial infarction.

For over 2 millennia, physicians have strived to relieve pain, heal, and cause no harm. However, we depend on therapeutic drugs that have side effects and unknown pleiotropic effects. A host of publications and media coverage over the last 2 years alerted us to cardiovascular (CV) risks associated with chronic use of nonselective, nonsteroidal antiinflammatory drugs (NSAIDs) and selective cyclooxygenase (COX)-2 inhibitors (COXIBs). The publicity elicited concern in patients taking these drugs for their valuable antipyretic, analgesic, and antiinflammatory properties and made physicians more vigilant about side effects such as gastrointestinal ulceration, inhibition of platelet aggregation and thrombosis, inhibition of uterine motility, inhibition of prostaglandin (PG)-mediated renal function, and hypersensitivity reactions.