Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor
To The Editor: Dr Mukherjee and colleagues1 reported that COX-2 inhibitors may induce prothrombotic
activity. However, there is an important reason for thinking that COX-2 inhibitors
might protect against CV events. Thrombosis is thought to occur when the fibrin
coat over plaques is broken down by collagenase released from overactive macrophages.3 Since such macrophages express high levels of COX-2,
COX-2 inhibitors should reduce their activity and also should act synergistically
with the antiplatelet activity of COX-1 inhibitors.
McGeer PL, McGeer EG, Yasojima K. Cardiovascular Events and COX-2 Inhibitors. JAMA. 2001;286(22):2808-2813. doi:10.1001/jama.286.22.2808