Which NSAIDs are known for having a significant increase in cardiovascular risk?

The identification of Celecoxib and NSAIDs under specific conditions as having a significant increase in cardiovascular risk is rooted in their pharmacological properties and the clinical evidence associated with their use.

Celecoxib is a selective COX-2 inhibitor, which was developed to reduce gastric side effects associated with traditional NSAIDs. However, studies have shown that while it may have a lower risk of gastrointestinal complications, it can increase the risk of cardiovascular events like heart attack and stroke, especially at higher doses or in patients with pre-existing cardiovascular risk factors. The COX-2 enzyme is involved in the production of prostacyclin, a molecule that helps to dilate blood vessels and inhibit platelet aggregation. By selectively inhibiting COX-2, Celecoxib can upset the balance between thromboxane (which promotes platelet aggregation and vasoconstriction) and prostacyclin, leading to increased cardiovascular risk.

Additionally, the phrase "NSAIDs under specific conditions" refers to the broader class of non-selective NSAIDs, some of which also demonstrate increased cardiovascular risk when used long-term, especially in patients with certain risk profiles such as pre-existing heart conditions, hypertension, or those who have multiple cardiovascular risk factors. This underscores the importance of evaluating the individual patient's