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]
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