Antibiotic Therapy Improves Endothelial Function in CAD With C. Pneumoniae

NEW YORK (Reuters Health) Feb 25 – Results of a randomized trial indicate that azithromycin treatment benefits patients who have coronary artery disease (CAD) and evidence of Chlamydia pneumoniae infection.
The finding is reported in a rapid access release from the March 19th issue of Circulation: Journal of the American Heart Association. "We have shown for the first time that antibiotic intervention improves endothelial function in patients with CAD," Dr. Juan Carlos Kaski, from St. George's Hospital Medical School, London, told Reuters Health.

Dr. Kaski and colleagues randomly assigned 40 men, mean 55 years of age, who had documented CAD and positive C. pneumoniae-IgG antibody titers, to azithromycin or placebo for 5 weeks.

At baseline and at the end of the trial, the researchers assessed flow-mediated dilation at the brachial artery and levels of E-selectin, von Willebrand factor, and C-reactive protein.

Mean flow-mediated dilation increased 2.1% (p < 0.005) in patients receiving azithromycin, while there was no significant change among patients receiving placebo, the investigators report. Azithromycin treatment also significantly reduced E-selectin and von Willebrand factor levels, but levels of C-reactive protein did not change significantly..

"The study was not designed to look at clinical outcomes, so we do not know if improved endothelial function will lead to better patient outcomes," Dr. Kaski said. "The question remains as to whether the antibiotic was effective because it had a bactericidal action or was it effective because it had an anti-inflammatory effect."

"It is too early to recommend antibiotic treatment in the treatment of CAD," Dr. Kaski concluded. "First we need to understand how antibiotics work in CAD and atherosclerosis before we know whether antibiotic therapy should be used or not.

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