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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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