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(Circulation. 1999;99:1555-1559.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Treatment of Helicobacter pylori and Chlamydia pneumoniae Infections Decreases Fibrinogen Plasma Level in Patients With Ischemic Heart Disease
From the Emergency Department (G.T., R.C., C.M., G.V., T. V. T., G.C.), Institute of Respiratory Disease (F.B., P.T., C.A.), Institute of Hygiene (M.L.R.), and Hemodynamic Unit (R.P.), Ospedale Maggiore, IRCCS, Milan, Italy.
Correspondence to Giuseppe Torgano, MD, Divisione di Medicina d'Urgenza, Ospedale Maggiore-IRCCS, Via F Sforza 35, 20122 Milano, Italy. E-mail medurg1{at}polic.cilea.it
Background—Chronic Chlamydia pneumoniae and Helicobacter pylori infections could be a risk factor for ischemic heart disease (IHD), possibly by increasing fibrinogen levels. The aim of our study was to evaluate changes in fibrinogen level in patients with IHD and H pylori and/or C pneumoniae positivity randomly assigned to antibiotic treatment.
Methods and Results—Eighty-four patients with chronic IHD, H pylori and/or C pneumoniae antibodies, and normal acute-phase reactants were randomly assigned to treatment or no treatment. Treatment consisted of omeprazole, clarithromycin, and tinidazole in H pylori–positive patients and clarithromycin alone in C pneumoniae–positive patients. The effect of treatment and other baseline variables on fibrinogen levels, determined at 6 months, was evaluated by multivariate analysis. Treatment significantly reduced fibrinogen level at 6 months in the overall study population and in the groups of patients divided according to H pylori or C pneumoniae positivity. In the 43 treated patients, mean (±SD) basal fibrinogen was 3.65±0.58 g/L, and mean final fibrinogen was 3.09±0.52 g/dL (P<0.001), whereas in the 41 untreated patients, mean basal and final fibrinogen levels were 3.45±0.70 and 3.61±0.71 g/L, respectively. The largest decrease was observed in patients with both infections. Fibrinogen changes were also significantly and negatively correlated with age.
Conclusions—Our data suggest that a short, safe, and effective course of antibiotic therapy might be suggested as a means of interacting with an "emerging" risk factor.
Key Words: ischemia • fibrinogen • H pylori • C pneumoniae
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