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(Circulation. 2002;106:2414.)
© 2002 American Heart Association, Inc.

Editorial

Chlamydia pneumoniae-Atherosclerosis Link

A Sound Concept in Search for Clinical Relevance

Franz-Josef Neumann, MD

From the Herz-Zentrum Bad Krozingen, Bad Krozingen, Germany.

Correspondence to Franz-Josef Neumann, MD, Herz-Zentrum Bad Krozingen, Südring 15. 79189 Bad Krozingen, Germany. E-mail Franz-Josef.Neumann@Herzzentrum.de

Key Words: Editorials • infection • immune system • arteriosclerosis • thrombosis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The potential role of Chlamydia pneumoniae (Cpn) in atherosclerosis has attracted considerable attention. On the basis of early encouraging results, it was anticipated that infection with Cpn might prove a novel treatable risk factor for atherosclerosis, with a relevance comparable to that of Helicobacter pylori in peptic ulcer disease. The effect of antibiotic treatment on clinical outcome became widely accepted as benchmark for the Cpn-atherosclerosis link. Several studies investigated macrolide antibiotics for secondary prevention in vascular disease.^1–4 Due to limited sample sizes, however, most of these trials need to be interpreted cautiously. At the 51st Annual Scientific Sessions of American College of Cardiology, 2002, two adequately sized antibiotic trials, WIZARD (Weekly Intervention with Zithromax for Atherosclerosis and its Related Disorders) and AZACS (AZithromycin in Acute Coronary Syndromes), were reported. The negative results of these trials deadened the enthusiasm for the role of Cpn in atherosclerosis. WIZARD included 7747 patients with previous myocardial infarction (MI) and elevated Cpn titers who were randomly assigned to placebo or azithromycin for 11 weeks. During 2-year follow-up, the composite of all-cause mortality, recurrent MI, revascularization, and hospitalization for angina was not significantly affected by antibiotic treatment. Likewise, AZACS did not show a significant effect of short-term treatment with azithromycin on 6-month rate of all-cause mortality, nonfatal MI, or recurrent ischemia requiring revascularization in 1400 patients with unstable angina.

See p 2428

Chain of Evidence Linking Cpn to Atherosclerosis

Since Saikku and co-workers⁵ reported the potential link between coronary disease and previous infection with Cpn in 1988, the association between Cpn and incident . . . [Full Text of this Article]

Related Article:

Reduced Progression of Early Carotid Atherosclerosis After Antibiotic Treatment and Chlamydia pneumoniae Seropositivity

Dirk Sander, Kerstin Winbeck, Jürgen Klingelhöfer, Thorleif Etgen, and Bastian Conrad
Circulation 2002 106: 2428-2433. [Abstract] [Full Text]

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