mobic and Coronary-Disease

Despite the use of heparin, aspirin, and other antiplatelet agents, acute coronary syndrome patients without ST-segment elevation remain at risk of cardiovascular thrombotic events. Given the role of inflammation in the pathogenesis of arterial thrombosis, we tested the hypothesis that the combination of meloxicam, a preferential COX-2 inhibitor, and heparin and aspirin would be superior to heparin and aspirin alone.. In an open-label, randomized, prospective, single-blind pilot study, patients with acute coronary syndromes without ST-segment elevation were randomized to aspirin and heparin treatment (n=60) or aspirin, heparin, and meloxicam (n=60) during coronary care unit stay. Patients then received aspirin or aspirin plus meloxicam for 30 days. During the coronary care unit stay, the primary outcomes variable of recurrent angina, myocardial infarction, or death was significantly lower in the patients receiving meloxicam (15.0% versus 38.3%, P=0.007). The second composite variable (coronary revascularization procedures, myocardial infarction, and death) was also significantly lower in meloxicam-treated patients (10.0% versus 26.7%, P=0.034). At 90 days, the primary end point remained significantly lower in the meloxicam group (21.7% versus 48.3%, P=0.004), as did the secondary end point (13.3% versus 33.3%, P=0.015) and the need for revascularization alone (11.7% versus 30.0%, P=0.025). No adverse complications associated with the meloxicam treatment were observed.. Meloxicam with heparin and aspirin was associated with significant reductions in adverse outcomes in acute coronary syndrome patients without ST-segment elevation. Additional larger trials are required to confirm the findings of this pilot study.

Topics: Acute Disease; Adult; Aged; Angina, Unstable; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Coronary Disease; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors; Drug Therapy, Combination; Electrocardiography; Endpoint Determination; Female; Fibrinolytic Agents; Follow-Up Studies; Heparin; Humans; Isoenzymes; Male; Meloxicam; Membrane Proteins; Middle Aged; Pilot Projects; Prostaglandin-Endoperoxide Synthases; Syndrome; Thiazines; Thiazoles; Treatment Outcome

Topics: Cardiovascular Diseases; Clinical Trials as Topic; Coronary Artery Disease; Coronary Disease; Cyclooxygenase 2; Cyclooxygenase 2 Inhibitors; Cyclooxygenase Inhibitors; Humans; Isoenzymes; Meloxicam; Membrane Proteins; Prostaglandin-Endoperoxide Synthases; Syndrome; Thiazines; Thiazoles