COURAGE binciken kalubale amfani da stents a cikin barga CAD marasa lafiya
An yi amfani da kwayoyin cutar a cikin marasa lafiya da cututtukan cututtuka (CAD) a cikin kotu na COURAGE, da farko aka ruwaito a shekara ta 2007. A cikin wannan gwaji, marasa lafiya da CAD masu zaman kansu sun kasance marasa galihu don karɓar magani mafi kyau duka kadai ko maganin lafiya mafi kyau tare da stents. Wannan bincike bai nuna bambanci tsakanin sakamakon kungiyoyi biyu ba bayan shekaru 4.6.
Tsayayya ga sakamakon sakamakon jarrabawa
Sakamakon jarrabawar COURAGE ya kamata dukkanin masu aikin likita na zuciya su sake gwadawa idan sunyi amfani da kwayoyi da kuma marasa lafiya. Amma yawancin masu kwakwalwa ba su canza ayyukansu ba game da stents. Dalilin su shi ne cewa mutane da yawa sun gaskata cewa bude buguwa tare da stents kawai dole ne ya fi tasiri fiye da magani a farfado da ciwon zuciya da kuma mutuwa. Saboda haka, sakamakon daga COURAGE dole ne kuskure. Sun yi imanin cewa akwai yiwuwar biyan bayan lokaci zai bayyana gaskiyar.
Amma a cikin watan Nuwambar 2015, an buga sakon karshe na COURAGE. Bayan kimanin shekaru 12 da suka biyo baya, har yanzu ba a ba da magunguna a kan likita mafi kyau.
Ƙarin bayanan COURAGE Trial
A cikin jarrabawar COURAGE, marasa lafiya 2,287 tare da barga CAD ("CAD" yana nufin cewa rashin ciwo akan cututtukan zuciya ba a faruwa) an bazu don karɓar kofin magani mafi kyau duka ko magani mafi mahimmanci tare da kwayoyi.
An haifar da sakamakon tashin hankali na zuciya da mutuwar.
Babu bambanci a sakamakon tsakanin kungiyoyin. Amma marasa lafiya marasa lafiya sunyi kula da alamun su na angina fiye da marasa lafiya a kan maganin miyagun ƙwayoyi, amma ba a inganta yanayin hadarin zuciya da mutuwa ba.
Binciken da aka biyo baya na 2015 ya dubi bambance-bambance-mace tsakanin 'yan kungiyoyi biyu. Bayan kimanin shekaru 11.9, babu wani bambanci mai ban mamaki. Sashi ashirin da biyar na marasa lafiya marasa lafiya sun mutu, idan aka kwatanta da kashi 24 cikin marasa lafiya da ke biye da maganin lafiya kawai.
Masu bincike sun dubi yawancin rukuni na marasa lafiya don ganin ko wasu sassan zasuyi kyau tare da stents. Ba su sami abin da ya yi ba.
Yaushe Ya kamata A Yi amfani da Sutsi?
Yanzu ya zama a sarari cewa ba za a yi amfani da sutura a matsayin hanyar farko ba a CAD don hana ciwon zuciya saboda cututtuka ba su da tasiri a kan hana damun zuciya a wannan yanayi fiye da maganin likita. A gaskiya ma, akwai hakikanin tambaya game da yawan nauyin stents da suke da amfani a duk don magance matsalolin angina .
Dole ne a yi amfani da alamomi , a CAD CAD, kawai lokacin da angina mai mahimmanci ke faruwa har yanzu duk da lafiyar lafiya.
Ta Yaya Za a Yi Magana game da sakamakon?
Sakamakon jarrabawar COURAGE suna dace da sabon tunanin akan CAD kuma yadda hare-haren zuciya ke faruwa. Zuciyar zuciya bata haifuwa ba ne ta alamar barga wanda ke ɗauka don kare wani maganin. Maimakon haka, ana haifar da wani sifa wanda ya raguwa, saboda haka ya haifar da kwatsam da jini a cikin maganin, wanda kuma ya kwantar da ƙwayar.
Rupturing da clotting yana yiwuwa kamar yadda zai faru a cikin wani takarda wanda ke hana kawai kashi 10 na maganin kamar yadda yake a cikin wanda ke hana kashi 80 cikin dari.
Yin jituwa da alamun "mahimmanci" zai taimaka wajen taimakawa duk wani angina da ake haifar da tacewa. Amma, a fili, ba zai rage haɗarin mummunan hare-haren zuciya ba-musamman tun da yake yawancin wadannan hare-haren na zuciya suna hade da alamun da masu kirkiro ke kira "maras muhimmanci."
Tsayar da raguwa da ƙananan plaques, don haka hana hana hare-haren zuciya, yana neman karin maganin likita maimakon "matsalar matsala." An fi dacewa da maganin kwayoyi da kuma canje-canje na rayuwa .
"Matsakaicin" maganin maganin na jijiyoyin zuciya (ƙananan sa su raguwa) yana buƙatar rikici mai tsanani na cholesterol, karfin jini, da ƙonewa. Har ila yau, yana buƙatar motsa jiki na yau da kullum da kuma yin watsi da kasuwa. Matsalar miyagun kwayoyi za ta hada da aspirin, statins, beta blockers, da kuma maganin jini (idan ya cancanta).
Idan kana da barga CAD- ko ko a'a ba dole ba ne don kula da angina-don gaske hana hare-haren zuciya za ka buƙaci kasancewa a kan wannan farfadowa na likita. Ya kamata ku tabbata a tattauna da likitan zuciyarku abin da zai zama mafi mahimmancin likita a yanayin ku.
> Sources:
> Boden WE, O'Rourke RA, Teo KK, et al. Mafi mahimmancin maganin likita tare da ko ba tare da PCI ba don ciwon sikila. N Engl J Med 2007; DOI: 10.1056 / NEJMe070829.
> Borden WB, Redberg RF, Mushlin AI, et al. Abubuwan da ke da magungunan likita a cikin marasa lafiya da ke jurewa ta hanyar shiga tsakani. JAMA 2011; 305: 1882-1889.
> Sedlis SP, Hartigan PM, Teo KK, et al. Hanyoyin PCI a kan Rayuwa Kan Dogaro da Magunguna tare da Ciwon Ischemic Stable Ischemic. New England Journal of Medicine . 2015; 373 (20): 1937-1946. Doi: 10.1056 / nejmoa1505532.