Background: The cardiovascular toxicity that is associated with cyclooxygenase-2 (COX-2) inhibitors is perhaps not a class effect, but may be rather limited to certain drugs in the class. Endothelial function and aortic stiffness are predictors of cardiovascular risk. The effect of celecoxib, a selective COX-2 inhibitor on acute smoking-induced vascular impairment is unknown.

Methods: We studied the effect of 200mg of celecoxib in 12 healthy smokers (mean age 29.5 years) according to a randomized, double-blind, crossover fashion. Endothelial function and aortic stiffness were evaluated with flow-mediated dilatation (FMD) of the brachial artery and carotid-femoral pulse wave velocity (PWV) respectively. Measurements were done before celecoxib/placebo and immediately after a regular cigarette (tar 14 mg, nicotine 1mg) that was smoked 3 hours after drug administration.

Results: Celecoxib blunted the smoking-induced increase in systolic BP (p < 0.05), but not in diastolic BP (p = NS). Celecoxib abrogated the smoking-related decrease in FMD (decrease by 2.1 vs 0.6%, p < 0.05, left figure). Moreover, the increase in PWV after smoking was significantly lower with celecoxib (increase by 0.69 vs 0.29 m/s, p < 0.05, right figure).

Conclusion. Selective COX-2 inhibition by celecoxib abolishes the endothelial dysfunction and aortic stiffening that is induced acutely by smoking. This finding provides further insights into the cardiovascular profile of this drug.