Abstract
Nonsteroidal anti-inflammatory drugs such as aspirin have been used widely for decades but are associated with gastrointestinal side effects. The newer generation of anti-inflammatory drugs, the COX-2 selective inhibitors, do not have gastrointestinal side effects, but at least one of them is reported to lead to an increase in thrombotic events. In his Perspective, Vane discusses new findings ( Cheng et al .) that shed light on why inhibiting COX-2 rather than both COX isoforms may lead to dysregulation of cardiovascular homeostasis.