Efficacy and safety of the cyclooxygenase 2 inhibitors parecoxib and valdecoxib in patients undergoing coronary artery bypass surgery
Journal of Thoracic and Cardiovascular SurgeryPublished 1 June 2003Open access
Elisabeth Ott, Nancy A. Nussmeier, Peter C. Duke, Robert Feneck, R. Peter Alston, Michael C. Snabes
Citations403
SJR quartileQ1
SJR score1.93
SNIP2.06
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
In patients undergoing coronary artery bypass grafting surgery, the cyclooxygenase 2 inhibitor combination, parecoxib/valdecoxib, was effective for postoperative analgesia, however, the 14-day treatment regimen also was associated with an increased incidence of serious adverse events overall and sternal wound infections in particular.
Abstract
In patients undergoing coronary artery bypass grafting surgery, the cyclooxygenase 2 inhibitor combination, parecoxib/valdecoxib, was effective for postoperative analgesia. However, the 14-day treatment regimen also was associated with an increased incidence of serious adverse events overall and sternal wound infections in particular. Therefore our study raises important concerns requiring their comprehensive evaluation in a large-scale trial before these cyclooxygenase 2 inhibitors are used in patients undergoing coronary artery bypass grafting surgery.
Keywords
Medicine
BMJCollaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients
6,893 Citations2002Antiplatelet Trialists Collaboration
Aspirin (or another oral antiplatelet drug) is protective in most types of patient at increased risk of occlusive vascular events, including those with an acute myocardial infarction or ischaemic stroke, unstable or stable angina, previous myocardian infarctions, stroke or cerebral ischaemia, peripheral arterial disease, or atrial fibrillation.
PubMedPain assessment: global use of the Brief Pain Inventory.
5,274 Citations1994Cleeland Cs, Ryan Km
The development of the Brief Pain Inventory and the various applications to which the BPI is suited are described, being adopted in many countries for clinical pain assessment, epidemiological studies, and in studies of the effectiveness of pain treatment.
New England Journal of MedicineAdverse Cerebral Outcomes after Coronary Bypass Surgery
1,892 Citations1996Gary W. Roach, Marc S. Kanchuger +13 more
Adverse cerebral outcomes after coronary bypass surgery are relatively common and serious; they are associated with substantial increases in mortality, length of hospitalization, and use of intermediate- or long-term care facilities.
JAMARisk of Cardiovascular Events Associated With Selective COX-2 Inhibitors
1,742 Citations2001Debabrata Mukherjee
The results from VIGOR showed that the relative risk of developing a confirmed adjudicated thrombotic cardiovascular event with rofecoxib treatment compared with naproxen was higher than that in the placebo group of a recent meta-analysis of 23 407 patients in primary prevention trials.
PainDevelopment of the Wisconsin Brief Pain Questionnaire to assess pain in cancer and other diseases
1,570 Citations1983Randall L. Daut, Charles S. Cleeland +1 more
The development of a self‐report instrument designed to assess pain in cancer and other diseases and the evaluated Wisconsin Brief Pain Questionnaire suggest that the BPQ is sufficiently reliable and valid for research purposes.
Anesthesia & AnalgesiaThe Value of ???Multimodal??? or ???Balanced Analgesia??? in Postoperative Pain Treatment
1,468 Citations1993Henrik Kehlet, J rgen B. Dahl
The existing knowledge concerning the efficacy of analgesic combination therapy from postoperative pain studies is summarized and primary emphasis will be placed on moderate and severe pain and the use of and need for combined analgesic regimens.
Annals of Internal MedicineRenal Dysfunction after Myocardial Revascularization: Risk Factors, Adverse Outcomes, and Hospital Resource Utilization
1,075 Citations1998Christina Mora Mangano, Laura S. Diamondstone +4 more
The Multicenter Study for Perioperative Ischemia (McSPI) Research Group studied 2400 patients who underwent myocardial revascularization with cardiopulmonary bypass to determine the incidence and characteristics of postoperative renal dysfunction and failure, the predictors of renal dysfunction [determined by the use of multivariate modeling techniques], and the effect of kidney dysfunction on in-hospital resource utilization and patient disposition after discharge.
The LancetRisk of upper gastrointestinal bleeding and perforation associated with Individual non-steroidal anti-inflammatory drugs
976 Citations1994La García Rodríguez, Hershel Jick
NSAIDS should be used cautiously in patients who have other risk factors for UGIB; these include advanced age, smoking, history of peptic ulcer, and use of oral corticosteroids or anticoagulants.
New England Journal of MedicineAspirin and Mortality from Coronary Bypass Surgery
670 Citations2002Dennis T. Mangano
Early use of aspirin after coronary bypass surgery is safe and is associated with a reduced risk of death and ischemic complications involving the heart, brain, kidneys, and gastrointestinal tract.
New England Journal of MedicineEffect of Dipyridamole and Aspirin on Late Vein-Graft Patency after Coronary Bypass Operations
523 Citations1984James H. Chesebro, Valentı́n Fuster +13 more
The results show that dipyridamole and aspirin continue to be effective in preventing vein-graft occlusion late after operation, and it is believed that such treatment should be continued for at least one year.
Archives of Internal MedicineConsumption of NSAIDs and the Development of Congestive Heart Failure in Elderly Patients
512 Citations2000John Page, David Henry
The burden of illness resulting from NSAID-related CHF may exceed that resulting from gastrointestinal tract damage and was increased to a greater extent with long half- life than with short half-life drugs.
CHEST JournalPain Location, Distribution, and Intensity After Cardiac Surgery
411 Citations2000Xavier M. Mueller, Francine Tinguely +4 more
In this patient population, the pain intensity diminished from POD 3 onward, although its distribution did not vary significantly during the first postoperative week, and pain location changed with time, with more osteoarticular type pain at the end of the firstPostoperative week.
CirculationCardiovascular Thrombotic Events in Controlled, Clinical Trials of Rofecoxib
355 Citations2001Marvin A. Konstam, Matthew R. Weir +5 more
This analysis provides no evidence for an excess of CV events for rofecoxib relative to either placebo or the non-naproxen NSAIDs that were studied.
Journal of Thoracic and Cardiovascular SurgeryMultivariate discriminant analysis of the clinical and angiographic predictors of operative mortality from the Collaborative Study in Coronary Artery Surgery (CASS)
309 Citations1980John W. Kennedy, George C. Kaiser +7 more
There is a strong association of OM with advanced age, female sex, and variables associated with left ventricular dysfunction, and the risk of OM for an individual patient may be estimated with the use of these clinical and angiographic characteristics predictive of OM.
Journal of Thoracic and Cardiovascular SurgeryWarm heart surgery
299 Citations1991Samuel V. Lichtenstein, Kassam A. Ashe +4 more
As one of the part of book categories, warm heart surgery always becomes the most wanted book.
Archives of Internal MedicineNSAIDs Associated With Increased Risk of Congestive Heart Failure in Elderly Patients Taking Diuretics
298 Citations1998Eibert R. Heerdink, H G Leufkens +4 more
Use of NSAIDs in elderly patients taking diuretics is associated with a 2-fold increased risk of hospitalization for CHF, especially in those with existing serious CHF.
The American Journal of CardiologyComparison of thromboembolic events in patients treated with Celecoxib, a Cyclooxygenase-2 specific inhibitor, versus Ibuprofen or Diclofenac
231 Citations2002William B. White, Gerald A. Faich +6 more
The American Journal of MedicineEpidemiologic assessment of the safety of conventional nonsteroidal anti-inflammatory drugs
176 Citations2001Sonia Hernández–Dı́az, Luis A. García‐Rodríguez
The effects of various factors, such as NSAID dose, duration of treatment, patient age, and ulcer history, on the incidences of these adverse side effects are summarized.
JAMAEffects of Acadesine on Myocardial Infarction, Stroke, and Death Following Surgery<subtitle>A Meta-analysis of the 5 International Randomized Trials</subtitle>
152 Citations1997Dennis T. Mangano
The results of this meta-analysis indicate that in patients undergoing CABG surgery, treatment with acadesine before and during surgery can reduce early cardiac death, MI, and combined adverse cardiovascular outcomes.
American Journal of TherapeuticsValdecoxib, a COX-2???Specific Inhibitor, Is an Efficacious, Opioid-Sparing Analgesic in Patients Undergoing Hip Arthroplasty
141 Citations2002Frédéric Camu, Tessa Beecher +2 more
Pre-and postoperative administration of valdecoxib reduces the amount of morphine required for postoperative pain relief and provides greater analgesic efficacy compared with morphine alone, which has significant clinical utility for acute pain management in orthopedic surgery patients.
The American Journal of MedicineCyclooxygenase inhibition and thrombogenicity
137 Citations2001Francesca Catella-Lawson, Leslie J. Crofford
Future studies are needed to assess the antithrombotic properties of commonly used NSAIDs, the hypothetical thrombogenicity of COX-2-specific inhibitors in high-risk patients, the need for concomitant aspirin with selective versus nonselective COX inhibitors, and the antiplatelet and gastric toxicity of the aspirin/COX- 2-specific inhibitor combination in comparison with the aspirin-conventional NSAID combination.
Critical Care MedicineEffect of patient-controlled analgesia on pulmonary complications after coronary artery bypass grafting
130 Citations1999René Gust, Sabine Pecher +4 more
PCA significantly decreases postoperative pulmonary atelectasis in patients after coronary artery bypass grafting when compared with nurse-controlled analgesia and experiences a higher quality of analgesia, and it is concluded that treatment with PCA may reduce respiratory complications after cardiac surgery.
The American Journal of MedicineGastrointestinal toxic side effects of nonsteroidal anti-inflammatory drugs and cyclooxygenase-2–specific inhibitors
123 Citations2001Frank Buttgereit, Gerd R Burmester +1 more
This article critically reviews the data on gastrointestinal toxic side effects for conventional NSAIDs without as well as with prevention therapy and compares these data with those for the CSIs, namely, celecoxib and rofecoxib.
JAMAEffects of acadesine on myocardial infarction, stroke, and death following surgery. A meta-analysis of the 5 international randomized trials. The Multicenter Study of Perioperative Ischemia (McSPI) Research Group
118 Citations1997Dennis T. Mangano
The results of this meta-analysis indicate that in patients undergoing CABG surgery, treatment with acadesine before and during surgery can reduce early cardiac death, MI, and combined adverse cardiovascular outcomes.
Canadian Journal of Anesthesia/Journal canadien d anesthésieNon-steroidal anti-inflammatory drugs in treatment of postoperative pain after cardiac surgery
116 Citations2000Marja Hynninen, Davy Cheng +5 more
Diclofenac appears to have the best analgesic effects by reducing the morphine and other analgesic requirement postoperatively, and may be used for anaalgesia management post CABG surgery in selected patients.
Clinical TherapeuticsA double-blind, randomized comparison of intramuscularly and intravenously administered parecoxib sodium versus ketorolac and placebo in a postâoral surgery pain model
100 Citations2001S. Daniels
Parecoxib IV and IM provided effective analgesia and the 40-mg dose was comparable to ketorolac 60 mg on most measures of analgesia but had a longer duration of action.
The American Journal of MedicineRenal aspects of treatment with conventional nonsteroidal anti-inflammatory drugs versus cyclooxygenase-2–specific inhibitors
98 Citations2001Andrew Whelton
This review will summarize the known information defining the mechanisms by which these renal syndromes and related cardiovascular NSAIDs-induced side effects evolve and will characterize the “at-risk” NSAID consumer populations, together with approaches to the prevention and management of these diverse NSAID-related side effects.
Anesthesia & AnalgesiaPulmonary Function After Cardiac and Thoracic Surgery
85 Citations1999Charles Weissman
The pulmonary changes after surgery involving the thoracic cavity and the consequences of modern pain management techniques are examined.
PubMedStudies of controlled reperfusion after ischemia. XXI. Reperfusate composition: superiority of blood cardioplegia over crystalloid cardioplegia in limiting reperfusion damage--importance of endogenous oxygen free radical scavengers in red blood cells.
78 Citations1991Pierre Julia, Gerald D. Buckberg +3 more
Clinical Pharmacology & TherapeuticsAnalgesic efficacy of a combination of hydrocodone with ibuprofen in postoperative pain
74 Citations1999Gilder L. Wideman, Marie Keffer +4 more
In a factorial analysis, both the hydrocodone and ibuprofen effects were significant for most summary measures of analgesia, whereas results of the interaction contrast were consistent with the concept that the analgesic effect of the combination represents the additive analgesia of its 2 constituents.
Anesthesia & AnalgesiaPulmonary Function After Cardiac and Thoracic Surgery
71 Citations1999Charles Weissman
Journal of Thoracic and Cardiovascular SurgeryStudies of controlled reperfusion after ischemia
65 Citations1991Pierre Julia, Gerald D. Buckberg +3 more
Blood cardioplegic solutions containing their own endogenous free radical scavengers are superior to crystalloid cardiographers' solutions, because they limit oxygen-mediated perfusion damage and restore contractile function.
PubMedAlternative techniques of cardioplegia.
62 Citations1992T. Yau, Richard D. Weisel +6 more
Intermittent cold cardioplegia inhibited mitochondrial function but prevented the degradation of adenine nucleotides, while warm antegrade and warm retrograde techniques resulted in the greatest degree of anaerobic lactate production but did not increase morbidity and mortality.
The American Journal of MedicineEfficacy of cyclooxygenase-2–specific inhibitors
60 Citations2001Grant W. Cannon, Ferdinand C. Breedveld
Multiple studies in patients with osteoarthritis, rheumatoid arthritis, and acute pain have now confirmed that the clinical efficacy of COX-2-specific inhibitors is similar to that of conventional NSAIDs.
Canadian Journal of Anesthesia/Journal canadien d anesthésieRectal indomethacin reduces postoperative pain and morphine use after cardiac surgery
59 Citations1999Theodore Rapanos, Patricia Murphy +4 more
The combination of indomethacin with morphine after cardiac surgery results in reduced postoperative pain scores and opioid use without an increase in side effects.
Expert Opinion on Investigational DrugsEvaluation of intravenous parecoxib for the relief of acute post-surgical pain
50 Citations2000Kewal K. Jain
Parecoxib fulfils some of the desirable characteristics of an ideal non-narcotic analgesic for severe post-surgical pain and has application in other acutely painful conditions.
British Journal of AnaesthesiaKetorolac, diclofenac and ketoprofen are equally efficacious for pain relief after total hip replacement surgery
34 Citations1998P. A. Kostamovaara, H. Hendolin +2 more
There was no significant difference between groups in postoperative pain in 85 patients after hip replacement surgery under spinal anaesthesia in a prospective, double-blind, randomized study.
The American Journal of MedicineRecommendations for the clinical use of cyclooxygenase-2–specific inhibitors
17 Citations2001Peter E. Lipsky
Current evidence indicates that COX-2–specific inhibitors should be considered whenever conventional NSAID therapy is required, and patients currently using conventional NSAIDs should therefore be considered for treatment with a COx-2-specific inhibitor based on the GI risk factors, as well as on the patient's need for ongoing analgesic and/or anti-inflammatory therapy.