COX isoforms in the cardiovascular system: understanding the activities of non-steroidal anti-inflammatory drugs

Nat Rev Drug Discov. 2006 Jan;5(1):75-86. doi: 10.1038/nrd1929.


Non-steroidal anti-inflammatory drugs (NSAIDs) inhibit the formation of prostanoids by the enzyme cyclooxygenase (COX). Work in the past 15 years has shown that COX exists in two forms: COX1, which is largely associated with physiological functions, and COX2, which is largely associated with pathological functions. Heated debate followed the introduction of selective COX2 inhibitors around 5 years ago: do these drugs offer any advantages over the traditional NSAIDs theywere meant to replace, particularly in regard to gastrointestinal and cardiovascular side effects? Here we discuss the evidence and the latest recommendations for the use of selective inhibitors of COX2 as well as the traditional NSAIDs.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents, Non-Steroidal* / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal* / pharmacology
  • Anti-Inflammatory Agents, Non-Steroidal* / therapeutic use
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular System / drug effects*
  • Cyclooxygenase 1 / metabolism*
  • Cyclooxygenase 2 / metabolism*
  • Cyclooxygenase Inhibitors* / adverse effects
  • Cyclooxygenase Inhibitors* / pharmacology
  • Cyclooxygenase Inhibitors* / therapeutic use
  • Humans


  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase Inhibitors
  • Cyclooxygenase 1
  • Cyclooxygenase 2