Azithromycin for the Secondary Prevention of Coronary Events

Since Chlamydia pneumoniae is believed to be involved in the pathogenesis of coronary artery disease, this study investigated whether antibiotic therapy with azithromycin to eliminate C. pneumoniae would reduce the risk of coronary events. There was no beneficial effect associated with azithromycin. This study, along with that reported by Cannon et al. in this issue of the Journal, does not support the idea that C. pneumoniae has a significant pathogenic role in coronary artery disease. Since Chlamydia pneumoniae is believed to be involved in the pathogenesis of coronary artery disease, this study investigated whether antibiotic therapy with azithromycin to eliminate C. pneumoniae would reduce the risk of coronary events. There was no beneficial effect associated with azithromycin. An association between Chlamydia pneumoniae and atherosclerosis, originally suggested by seroepidemiologic studies, 1 , 2 was confirmed by a series of investigations demonstrating the presence of the organism in atherosclerotic lesions by four different methods. 3 – 6 The etiologic or pathogenic significance of this association needs to be determined. Through basic-science studies of possible mechanisms and animal-model studies of atherosclerosis, data on the role of C. pneumoniae in atherosclerosis have accumulated. 7 , 8 The presence of C. pneumoniae in atherosclerotic lesions raises the possibility that antibiotic treatment might have a favorable effect on the course of coronary heart disease. A trial of antibiotic treatment . . .