Ba dukkan waɗannan kwayoyi sunyi daidai da wannan hadarin ba
Magungunan anti-inflammatory mai cututtuka (NSAIDs) suna daga cikin magungunan da aka fi amfani da su a duniya. Suna da tasiri a rage rage kumburi da ciwo kuma suna samuwa duka biyu ta takardar sayan magani da kuma kan kanti.
Duk da haka, yawancin kwayoyi yanzu an san su don haɓaka ƙwayar cututtukan zuciya, ciki har da ciwon sikila mai ciwo (ACS) , rashin zuciya zuciya , da yiwuwar fibrillation .
Girman wannan kara haɗari yana da ƙananan ƙananan. Amma haɗarin yana ƙarawa tare da amfani mai tsabta kuma tare da ƙananan canji, kuma yana da mahimmanci a cikin mutanen da ke da cututtukan zuciya na zuciya. Bugu da ari, haɗarin ya fi girma tare da wasu NSAID fiye da wasu.
(Lura: Aspirin shine mafi tsofaffi kuma mafi yawan amfani da NSAID.) Duk da haka, aspirin rage hadarin zuciya, kuma ba za a tattauna a cikin wannan labarin ba.Za ka iya karanta game da aspirin a nan .)
Nau'ikan NSAIDS
Wadanda ba aspirin NSAIDs ke aiki ta hanyar hana gizon cyclooxygenase (COX) , yana haifar da rage yawan samar da prostaglandins wanda ke haifar da zafi da kumburi.
Akwai hakikanin abubuwa biyu COX enzymes - COX-1 da COX-2 - waɗanda suke da tasiri daban-daban. COX-2 yana haɗuwa da ciwo da ƙumburi, yayin da COX-1 yana da wasu ayyuka, ciki har da kare fuskar ciki daga acid.
Saboda haka, an rarraba NSAIDS ne ta hanyar toshe kawai COX-2 ("Zaɓaɓɓe" NSAIDS), ko kuma suna toshe duka COX-1 da COX-2 ("nonselective" NSAIDs).
Asali na NSAIDs, irin su ibuprofen (Advil) da naproxen (Aleve), duk sun kasance NSAIDS marasa dacewa. Saboda sun toshe COX-1 suna haɗuwa da fushi.
Kamfanonin ƙwayoyi sunyi ƙoƙari wajen ƙaddamar da NSAID zabi wanda ke toshe kawai COX-2, don rage yawan rikitarwa. Don haka a yanzu akwai da dama NSAID masu zaɓuɓɓuka, ciki har da celecoxib (Celebrex) da kuma mice (Mobic).
Wadannan kwayoyi sune sababbin sababbin, kuma basu samuwa a cikin nau'in kwayar halitta ko a kan takaddama.
Raunin jijiyoyin jini tare da NSAIDs
Ƙara yawan hatsarin zuciya tare da NSAIDs an fara lura da shi tare da zabi mai suna Rofecoxib (vioxx) NSAID, wanda ya haifar da babbar tallace-tallace da yawancin hukunce-hukuncen da aka yi wa masu sana'a, Merck. An kawar da Vioxx daga kasuwa.
Tun daga wancan lokaci yawancin bincike na asibitoci sun nuna cewa wannan karuwa a cikin hadarin zuciya na zuciya shine hade da dukkan NSAIDs, dukansu wadanda basu da mahimmanci NSAID da kuma sababbin kwayoyi masu zafin jiki na COX-2.
Tare da kusan dukkanin NSAID, ƙwayar cutar na zuciya yana ƙaruwa tare da tsawon amfani da waɗannan kwayoyi, tare da sashi da aka yi amfani dashi, tare da haɗarin zuciya na zuciya na mutumin da ke shan kwayoyi.
Shin wasu NSAIDs sun "mafi aminci" fiye da wasu?
Bayanan da aka kwatanta girman haɗarin cutar zuciya ta hanyar wasu NSAID takamaiman sun rasa. Saboda yawancin wadannan kwayoyi da suke samuwa, da kuma karamin haɗarin haɗari, gudanar da gwaje-gwaje na asibiti da ake bukata don yin watsi da bambance-bambance zai zama tsada.
Duk da haka, an buga mahimmanci na binciken binciken asibiti a shekara ta 2013. Wannan bincike ya nuna cewa hadarin cututtukan zuciya na zuciya ya karu sosai idan aka kwatanta da placebo da matsayi mai girma diclofenac (mai ba da izinin NSAID), tare da dukan NSAID zaɓaɓɓe.
Bugu da ƙari, an samu ci gaba da haɗari tare da ibuprofen wanda ba a mahimmanci ba. Kuma babu ƙara yawan hadari da naproxen.
Wannan bincike-bincike ba a la'akari da shi ba. Yawancin masana sun kafa ra'ayi cewa duk NSAIDs, na duka biyu, ya kamata a kara haɗarin hadarin zuciya.
Duk da haka, idan NSAID ya kamata a yi amfani da shi a cikin wani mutum da ya damu game da kara yawan haɗarin zuciya, mafi yawan masana zasu bada shawara akan wannan.
Sauran damuwa na Cardiac da suka shafi NSAIDS
Bugu da ƙari don kara yawan ƙwayar zuciya, abubuwan biyu na NSAID kuma suna haɗuwa da karuwa a cikin karfin jini idan aka yi amfani da lokaci-lokaci.
Bugu da ƙari, yawancin wadanda ba su da izini NSAIDs suna tsangwama tare da amfani masu amfani da aspirin yana kan plalets, saboda haka yana hana maganin aspirin prophylactic. Ba'a ga wannan tsangwama ba, duk da haka, tare da NSAID diclofenac ba tare da izini ba, ko tare da NSAIDs zaɓaɓɓe.
Layin Ƙasa
Yayin da Vioxx ya samu duk tallar, sai dai ya nuna cewa duk NSAID yana bayyana ƙara yawan cututtuka na zuciya kamar yadda aka saba (tare da banban da aka riga aka lura).
Ga mutanen da ke fama da ƙwayar cutar na zuciya, dole ne a yi amfani da NSAID a mafi mahimmancin ƙimar don gajeren lokaci. Idan haɗarin zuciyarka ya karu , naproxen zai yiwu ka zabi NSAID.
Duk wanda ke dauke da hauhawar jini dole ne ya sani cewa NSAIDs na iya ƙara yawan karfin jini kuma rage tasirin maganin antihypertensive .
Duk wanda ke shan aspirin don maganin cututtuka da cutar cututtukan zuciya ya kamata ya guje wa wadanda ba su da ma'ana NSAID a duk lokacin da zai yiwu. Idan za a yi amfani da NSAID, ya kamata a dauki akalla sa'o'i biyu bayan aspirin.
Sources:
Fosbøl EL, Folke F, Jacobsen S, et al. Dama-haɗarin CV da ke faruwa tare da NSAIDs tsakanin mutane masu lafiya. Circ Cardiovasc Qual sakamakon 2010; DOI: 10.1161 / CIRCOUTCOMES.109.861104.
Coxib da na gargajiya na NSAID Trialists '(CNT) Collaboration, Bhala N, Emberson J, et al. Hanyoyin ƙwayoyin cuta da kwayoyin cututtuka marasa magungunan cututtuka: maganin-kwaskwarima na bayanan mai shiga tsakani daga gwaje-gwaje bazuwar. Lancet 2013; 382: 769.