By the way, doctor: If COX-2 drugs are anti-inflammatory, why are they associated with heart attacks?

Q. I'm confused. I've read articles about heart disease being caused by inflammation. If the COX-2 drugs are anti-inflammatory, why do they seem to make heart disease worse, not better?

A. That's a good question and one that's certainly been in the news!

First, some background. For many years, doctors thought that heart attacks could be fully explained by cholesterol buildup. We knew that the atherosclerotic plaques that narrow coronary arteries are filled with LDL ("bad") cholesterol. There was also good evidence from clinical trials that drugs that lower blood levels of total cholesterol and LDL cholesterol reduce the risk of a heart attack.

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