Inflammation mediated on intracell...

Inflammation mediated on intracellular pathogens such as Chlamydia pneumoniae has been conception to contribute to the atherosclerotic proces Antigens to C pneumoniae and other immunohistologic evidence have been establish in connection with coronary disease. The Weekly Intervention with Zithromax for Atherosclerosis and its Related Disorders (WIZARD) consideration was designed to assess the validity of 12 weeks of treatment with azithromycin compared with placebo in succession a stable population of patients with previous myocardial infarction (MI) and evidence of C pneumoniae infection.

Eligible patients had documented MI more than six weeks before the meditation with evidence of C. pneumoniae infection. Patients meeting eligibility criteria were randomly assigned to receive azithromycin in a dosage of 600 mg one time daily for three days, then one time weekly for the subsequent 11 weeks, or matching placebo. Primary circumstances included death by any cause, renewed MI, coronary revascularization procedure (coronary artery bypass graft surgery or percutaneous coronary intervention), or hospitalization for angina, whichever came first. Secondary marked occurrences included a noncoronary atherosclerotic issue such as stroke, cardiovascular death, or hospitalization for congestive heart failure.

Patients were randomized in couple phases, with 3,538 participants in the first dispose and 4,209 in the next to the first group; more than 90 percent complet the application of mind treatment. Mean and median follow-up times were 25 month in the first assemblage and 14 months in the other group.

The annualized primary affair rate in the placebo clump was 8.02 percent. Azithromycin treatment was associated with a 7 percent nonsignificant reduction in risk of a primary affair with no significant risk reduction for any primary occurrence component. No significant association between C pneumoniae titers and treatment force was observed. A trend toward differences in risk reduction was observ in subgroup of patients. In the subgroup of patients with diabetes who also smok the annualized primary adventure rate for the primary close point was 14.6 percent with azithromycin versus 53 percent with placebo.

A 12-week course of azithromycin was not rest to lower rates of death, nonfatal reinfarction, hospitalization for angina, or coronary revascularization in patients with previous MI and evidence of in all senses to C. pneumoniae. Some issue of azithromycin treatment might come into one's head in some high-risk populations; further studies are wanted to confirm these observations. C pneumoniae titers were not predictive of the evolution of an event during the subject of attention The authors do not commit instituting azithromycin treatment for prevention of returning coronary heart disease in patients with previous MI.

O'Connor CM et al. Azithromycin for the secondary prevention of coronary heart disease adventures The WIZARD study: a randomized controll trial. JAMA September 17 2003;290;1459-66

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