The ACADEMIC study in perspective (azithromycin in coronary artery disease: Elimination of myocardial infection with chlamydia)

Citation
Jl. Anderson et Jb. Muhlestein, The ACADEMIC study in perspective (azithromycin in coronary artery disease: Elimination of myocardial infection with chlamydia), J INFEC DIS, 181, 2000, pp. S569-S571
Citations number
15
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Clinical Immunolgy & Infectious Disease",Immunology
Journal title
JOURNAL OF INFECTIOUS DISEASES
ISSN journal
0022-1899 → ACNP
Volume
181
Year of publication
2000
Supplement
3
Pages
S569 - S571
Database
ISI
SICI code
0022-1899(200006)181:<S569:TASIP(>2.0.ZU;2-C
Abstract
Chlamydia pneumoniae, a common cause of respiratory infection, is vasotropi c and frequently found in human atheromas. Whether it plays a causal role i n coronary artery disease (CAD) is uncertain. The effects of 3 months of az ithromycin treatment or placebo were tested in 302 patients with chronic CA D seropositive to C. pneumoniae at 3-6 months. Azithromycin reduced a globa l rank sum score of 4 inflammatory markers (C-reactive protein [CRP], inter leukin [IL]-1, IL-6, tumor necrosis factor-alpha; P = .011) and a global ra nk sum change score (+/- SD) (from 535 +/- 201 to 587 +/- 190; P = .027) at 6 (but not 3) months. Change scores for CRP and IL-6 and median IL-1 lever s were lower. C, pneumoniae IgG and IgA antibody titers were unchanged. Cli nical cardiovascular events at 6 months did not differ between groups (azit hromycin, 9; placebo, 7). Infections were reduced and drug was well tolerat ed. Thus, azithromycin caused modest but significant reductions in markers of inflammation, but differences in clinical events were not evident at 6 m onths. However, power was limited and conclusions should await results of t he 2-year evaluation and larger studies.