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The Journal of the American Board of Family Medicine 19:178-182 (2006)
© 2006 American Board of Family Medicine

Clinical Review

Can Natriuretic Peptide Levels Predict the Cardiovascular Complications of COX-2 Inhibitors and Nonsteroidal Anti-inflammatory Drugs?

Robert P. Blankfield, MD, MS

From the Department of Family Medicine, Case Western Reserve University School of Medicine, Berea, OH

Correspondence: Corresponding author: Robert P. Blankfield, MD, 201 Front Street, Suite 101, Berea, OH 44017 (E-mail address: blankfield{at}adelphia.net)

There is evidence that fluid retention, whether due to a disease process or due to a medication, is associated with a number of cardiovascular diseases, including heart failure, strokes, coronary artery disease, and cardiovascular death. There is additional evidence that fluid retention that manifests as increased intravascular volume adversely affects cardiovascular outcomes. Because natriuretic peptide levels reflect intravascular volume and pressure, it is hypothesized that when patients are prescribed medications that promote fluid retention—such as non-selective nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors—monitoring natriuretic peptide levels before and after initiating the medication may allow these medications to be used more safely.




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K. Brune, H. A. Katus, J. Moecks, E. Spanuth, A. S. Jaffe, and E. Giannitsis
N-Terminal Pro-B-Type Natriuretic Peptide Concentrations Predict the Risk of Cardiovascular Adverse Events from Antiinflammatory Drugs: A Pilot Trial
Clin. Chem., July 1, 2008; 54(7): 1149 - 1157.
[Abstract] [Full Text] [PDF]


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Copyright © 2006 by the American Board of Family Medicine.