Which of the following is the primary reason why selective COX-2 inhibitors are associated with an increased risk of cardiovascular events?
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Correct answer: They inhibit prostacyclin (PGI2) without inhibiting thromboxane A2 (TXA2)
COX-2 inhibition reduces endothelial prostacyclin (a vasodilator and anti-aggregant) but does not affect platelet-derived thromboxane (a vasoconstrictor and pro-aggregant). This imbalance shifts the vascular environment toward a pro-thrombotic state.
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