असम्भाव्य ही है स्टे -टीन्स(Statins) से खून के थक्कों को मुल्तवी रख पाना
Blood Clots Unlikely To Be Prevented By Statins
Despite previous studies suggesting the contrary, statins (cholesterol-lowering drugs) may not prevent blood clots (venous thrombo-embolism) in adults, according to a large analysis by international researchers published in this week's PLOS Medicine.
Despite previous studies suggesting the contrary, statins (cholesterol-lowering drugs) may not prevent blood clots (venous thrombo-embolism) in adults, according to a large analysis by international researchers published in this week's PLOS Medicine.
In 2009, an additional analysis of data from a randomized controlled trial called the JUPITER trial reported that the statinrosuvastatin halved the risk of venous thromboembolic events among apparently healthy adults. However, this finding was based on a small number of patients who had thromboembolic events (34 vs 60). To gather more evidence about the possible benefits of statins, a group of international researchers led by Kazem Rahimi from the George Centre for Healthcare Innovation at the University of Oxford in the UK, combined the results (performed a meta-analysis) of 29 suitable published and unpublished randomised controlled trials of the effects of statins involving over 100 000 participants and more than 1000 events: Only two studies presented venous thrombotic events in the published report, but such events had been recorded as adverse events in all of the included trials, which the authors were able to include in their analysis.
In the combined analysis, the authors found that venous thrombosis occurred in 0.9% of people taking statins compared to 1% of people not taking statins, which suggests that statins have a very small, if any, effect. These results did not change when the authors excluded the findings of the JUPITER trial. The authors also found that there was no effect at all in people taking high doses and low doses of statins.
The authors conclude: "this study provides a more detailed assessment of the potential effects of statins (or higher dose statins) on venous thromboembolic events than has previously been possible. We were unable to confirm the large proportional reduction in risk suggested by some previous studies."
The authors add: "However, a more modest but perhaps clinically worthwhile reduction in venous thromboembolic events in some or all types of patient cannot be ruled out."
In an accompanying Perspective article, Frits Rosendaal from the Leiden University Medical Center in The Netherlands (uninvolved in the study) argues that even if the study cannot provide definite answers to the statin question, some tentative conclusions can be drawn. He says: "Firstly, that for the association between statins and venous thrombosis the methodologically strongest analysis shows at most a very small effect. Secondly, if we do not wish to discard the possibility of a beneficial effect for the whole class, any such effects are limited to rosuvastatin."
Blood Clots Unlikely To Be Prevented By Statins
.डॉ .अरविन्द मिश्रा जी को समर्पित है यह पोस्ट जिनके आग्रह पर इसकी पहल हुई है .
Despite previous studies suggesting the contrary, statins (cholesterol-lowering drugs) may not prevent blood clots (venous thrombo-embolism) in adults, according to a large analysis by international researchers published in this week's PLOS Medicine.
Venous
रुधिरवाहिनियों से (शिराओं से )जो खून दिल की ओर लौटता है वह वीनस कहलाता है .THROMBUS कहतें हैं खून के थक्के को .तथा थ्रामबोसिस कहतें हैं ,रक्त ज़माव या शिराअवरोध को .हृदय या रक्त नाली में थक्का ज़मने का यह एक गंभीर रोग है थ्रोमयोसिस .या थ्रोम्बो -एम्बोलिज्म .
EMBOLISM
यह वह रोगात्मक स्थिति है जिसमें हृदय को खून ले जाने वाली धमनी में कोई एमबोलस(खून का थक्का )कहीं ओर से आके फंस जाता है .EMBOLUS का बहु वचन है EMBOLI.
समझा जाता था ,खून में घुली चर्बी को घटाने वाली दवाएं (स्टेटइन्स ) शिराओं में बहते खून में थक्कों को भी बनने से रोकें रहतीं हैं .लेकिन एक व्यापक अध्ययन विश्लेषण के बाद यह अवधारणा एक खामखयाली ही सिद्ध हुई है .
२००९ में एक बेतरतीब नियंत्रित परीक्षण ( randomized controlled trial )"जुपिटर" किया गया था .पता चला था ROSUVASTATIN(रोसुवास्तेतिन/रोज़ुवास्टेटिन नामी एक स्टेटिन
) का नियमित सेवन साफ़ तौर पर तंदरुस्त दिखते लोगों में शिरावरोध के मामलों के जोखिम का वजन घटाके आधा कर देती है ,यानी वीनस थ्रोम्बो -एम्बोलिक इवेंट्स का वजन घटाके
आधा कर देती है .
लेकिन यह एक छोटा ट्रायल था जिसमें थ्रोम्बो -एम्बोलिक -इवेंट्स के कम ही मरीज़ शामिल किये गए थे ( ३४ बनाम ६० ).
स्तेतिंस के संभावित लाभ के और साक्ष्य जुटाने के लिए ऑक्सफोर्ड यूनिवर्सिटी के रिसर्चरों ने एक बड़ी पहल हाथ में ली .रिसर्चरों के इस समूह ने प्रकाशित और बे तरतीब नियंत्रित
लेकिन अ -प्रकाशित २९ अध्ययनों का जिनमें कुलमिलाकर १०,००० प्रतिभागी थे और वीनस -थ्रोम्बो -इवेंट्स के तकरीबन १००० मामले दर्ज़ हुए थे पूरा जायजा लिया .
प्रकाशित रिपोर्ट में ऐसे मात्र दो अध्ययन ही शामिल थे जिनमें इन इवेंट्स का उल्लेख किया गया था .लेकिन ये दोनों ही बदतरीन इवेंट्स थीं शामिल किये गए सभी परीक्षणों से .
कुल मिलाके हुआ क्या ?नतीज़ा वही ढ़ाक के तीन पात ?
जो रोज़ुवास्तेतिन ले रहे थे उनमें ०.९ % और जो नहीं ले रहे थे उनमें भी कुल १%मामले दर्ज़ हुए .ज़ाहिर है स्टेटिन की भूमिका नामालूम सी ही रही है थक्कों को मुल्तवी रखने में .जुपिटर ट्रायल को बाहर रखने पर भी नतीजे जस के तस रहे .रोसुवास्तेतिन की हाई या लो डोज़ लेते रहने का भी कोई असर नहीं देखा गया .
पूर्व में किये गए अध्ययनों के बरक्स यहाँ नतीजे उलट थे .स्टेटिन का कोई प्रत्यक्ष लाभ मिलता दिखलाई नहीं दिया .
Blood Clots Unlikely To Be Prevented By Statins
ज़नाब हिंदी में भी आयेगा ये आलेख .डॉ .अरविन्द मिश्रा जी को समर्पित है यह भी और वह पोस्ट जिनके आग्रह पर इसकी पहल हुई है .
Despite previous studies suggesting the contrary, statins (cholesterol-lowering drugs) may not prevent blood clots (venous thrombo-embolism) in adults, according to a large analysis by international researchers published in this week's PLOS Medicine.
In 2009, an additional analysis of data from a randomized controlled trial called the JUPITER trial reported that the statinrosuvastatin halved the risk of venous thromboembolic events among apparently healthy adults. However, this finding was based on a small number of patients who had thromboembolic events (34 vs 60). To gather more evidence about the possible benefits of statins, a group of international researchers led by Kazem Rahimi from the George Centre for Healthcare Innovation at the University of Oxford in the UK, combined the results (performed a meta-analysis) of 29 suitable published and unpublished randomised controlled trials of the effects of statins involving over 100 000 participants and more than 1000 events: Only two studies presented venous thrombotic events in the published report, but such events had been recorded as adverse events in all of the included trials, which the authors were able to include in their analysis.
In the combined analysis, the authors found that venous thrombosis occurred in 0.9% of people taking statins compared to 1% of people not taking statins, which suggests that statins have a very small, if any, effect. These results did not change when the authors excluded the findings of the JUPITER trial. The authors also found that there was no effect at all in people taking high doses and low doses of statins.
The authors conclude: "this study provides a more detailed assessment of the potential effects of statins (or higher dose statins) on venous thromboembolic events than has previously been possible. We were unable to confirm the large proportional reduction in risk suggested by some previous studies."
The authors add: "However, a more modest but perhaps clinically worthwhile reduction in venous thromboembolic events in some or all types of patient cannot be ruled out."
In an accompanying Perspective article, Frits Rosendaal from the Leiden University Medical Center in The Netherlands (uninvolved in the study) argues that even if the study cannot provide definite answers to the statin question, some tentative conclusions can be drawn. He says: "Firstly, that for the association between statins and venous thrombosis the methodologically strongest analysis shows at most a very small effect. Secondly, if we do not wish to discard the possibility of a beneficial effect for the whole class, any such effects are limited to rosuvastatin."
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