Quelle: Fachblatt Eur Heart J.

Herzinfarkt Prophylaxe: Ist Aspirin (ASS= Azetylsalizylsäure) doch nicht für die Herzinfarkt-Vorbeugung geeignet?

In den Jahren 2000-2003 erlitten in Finnland  33.309 Personen einen ersten Herzinfarkt. Jetzt zeigt eine wissenschaftliche Analyse dieser Patientengruppe, dass die Einnahme von Medikamenten, die wie das Aspirin zur Gruppe der nicht-steroidalen Antirheumatika (= NSAR) gehören, wider Erwarten nicht vor Herzinfarkten schützt.
Im Gegenteil. Das Herzinfarktrisiko war für alle diese Rheumamittel auf 1.4 erhöht. Möglicherweise ist das Herzinfarktrisiko bei den traditionellen NSAR sogar noch höher als bei den kürzlich in Verruf geratenen sog. COX-2-Hemmern vom Typ Vioxx ®.

Eur Heart J. 2006 Jul;27(14):1657-63. 

NSAID use and the risk of hospitalization for first myocardial infarction in the general population: a nationwide case-control study from Finland.

Helin-Salmivaara A, Virtanen A, Vesalainen R, Gronroos JM, Klaukka T, Idanpaan-Heikkila JE, Huupponen R.

Centre for Pharmacotherapy Development and Postgraduate School of Clinical Drug Research, University of Turku, PB 55, FIN-00301 Helsinki, Finland. arja.helin-salmivaara@rohto.fi

AIMS: To evaluate the risk of first myocardial infarction (MI) associated with the use of various non-steroidal anti-inflammatory drugs (NSAIDs) in the general population.

METHODS AND RESULTS: We conducted a population-based matched case-control study over the years 2000-3 in outpatient residents of Finland. In the nationwide Hospital Discharge Register 33 309 persons with first time MI were identified. A total of 138 949 controls individually matched for age, gender, hospital catchment area, and index day were selected from the Population Register. For combined NSAIDs, the adjusted odds ratio for the risk of first MI with current use was 1.40 (95% CI, 1.33-1.48).

The risk was similar for conventional (1.34; 1.26-1.43), semi-selective (etodolac, nabumetone, nimesulide, and meloxicam) (1.50; 1.32-1.71), and cyclo-oxygenase-2 (COX-2) selective NSAIDs (rofecoxib, celecoxib, valdecoxib, and etoricoxib) (1.31; 1.13-1.50).

Age of current user did not consistently modify the risk. No NSAID was associated with an MI-protective effect. All durations from 1 to 180 days of conventional NSAIDs and from 31 to 90 days duration of COX-2 selective NSAIDs were associated with an elevated risk of MI.

CONCLUSION: Current use of all NSAIDs is associated with a modest risk of first time MI.

PMID: 16731535 [PubMed - in process]