PTGS2 and myocardial infarction: They are used in the management of inflammatory pain, symptoms of osteoarthritis and rheumatoid arthritis with enhanced gastrointestinal safety profile compared to NSAIDs.43,44 Although, COXIBs cause lesser ulceration than traditional NSAIDs they can increase the risk of severe cardiovascular events such as heart attack, myocardial infarction (MI), and stroke.45–47 The safety of NSAIDs is influenced by multiple factors, not just their selectivity for COX-1 or COX-2.