doi: 10.1161/01.CIR.0000056032.56396.89
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(Circulation. 2003;107:1228.)
© 2003 American Heart Association, Inc.
Editorial |
Antibiotic Treatment of Atherosclerotic Cardiovascular Disease
From the Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle.
Correspondence to J. Thomas Grayston, MD, Department of Epidemiology, University of Washington, School of Public Health, Community Medicine, 1959 NE Pacific St, F263, Box 357236, Seattle, WA 98195. E-mail grayston@u.washington.edu
Key Words: Editorials • clinical trials • Chlamydia pneumoniae • antibiotics • atherosclerosis
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
It is just 17 years since Chlamydia pneumoniae was first described and 14 years since the first observational evidence of a possible association of the organism with coronary heart disease (CHD). For 5 years there was little interest in this association, but it has subsequently attracted an increasing number of investigators. The question of an association was settled by the frequent demonstration of C. pneumoniae in atherosclerotic lesions. However, understanding the pathogenic significance of the organism in the lesions has remained elusive.
See p 1253
Efforts to determine the pathogenic role of C. pneumoniae have included animal model studies, mechanistic studies, and clinical trials of antibiotic treatment. In rabbits and mice, C. pneumoniae pulmonary inoculation causes acceleration of atherosclerosis in the presence of elevated lipids. This effect of C. pneumoniae can be prevented by antibiotic treatment shortly after inoculation but not after the organism becomes established in the arteries. There are now a variety of studies of basic mechanisms that have shown ways that C. pneumoniae could play a role in the pathogenesis of atherosclerosis.
With the publication in this issue of Circulation of a clinical trial of antibiotic treatment of patients after acute myocardial infarctions,1 there are now 12 published clinical trials of antibiotic treatment for secondary prevention of atherosclerotic cardiovascular disease.1–12 Two additional trials, not yet published, were presented at the 2002 Annual Scientific Sessions of the American College of Cardiology. They are Weekly Intervention with Zithromax for Atherosclerosis and its Related Disorders (WIZARD) and AZithromycin in Acute
Related Article:
Circulation 2003 107: 1253-1259.
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