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Use of Biomarkers to Predict Cardiac Risk from Medications: Getting to the Heart of the Matter

In May 1999, the US Food and Drug Administration approved rofecoxib, the first nonsteroidal antiinflammatory drug (NSAID)1 with specific cyclooxygenase II (COX-II) activity. Soon to follow were the approvals of other COX-II inhibitors, including celecoxib. The hypothetical advantage of COX-II inhibitors over standard NSAIDs was that COX-II inhibitors reportedly caused fewer gastrointestinal complications, thanks to their avoidance of COX-I inhibition.

Not long after the release of COX-II agents, however, concerns were voiced about the theoretical potential for cardiovascular risk associated with their use. This concern was based on the fact that although nonselective NSAIDs inhibit both ...

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