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Previous Volume 352:1637-1645 April 21, 2005 Number 16 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Anderson, J. L. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Epidemiologic, laboratory, animal, and clinical studies suggest that there is an association between Chlamydia pneumoniae infection and atherogenesis. We evaluated the efficacy of one year of azithromycin treatment for the secondary prevention of coronary events.

Methods In this randomized, prospective trial, we assigned 4012 patients with documented stable coronary artery disease to receive either 600 mg of azithromycin or placebo weekly for one year. The participants were followed for a mean of 3.9 years at 28 clinical centers throughout the United States.

Results The primary end point, a composite of death due to coronary heart disease, nonfatal myocardial infarction, coronary revascularization, or hospitalization for unstable angina, occurred in 446 of the participants who had been randomly assigned to receive azithromycin and 449 of those who had been randomly assigned to receive placebo. There was no significant risk reduction in the azithromycin group as compared with the placebo group with regard to the primary end point (risk reduction, 1 percent [95 percent confidence interval, –13 to 13 percent]). There were also no significant risk reductions with regard to any of the components of the primary end point, death from any cause, or stroke. The results did not differ when the participants were stratified according to sex, age, smoking status, presence or absence of diabetes mellitus, or C. pneumoniae serologic status at baseline.

Conclusions A one-year course of weekly azithromycin did not alter the risk of cardiac events among patients with stable coronary artery disease.

Source Information

From the Departments of Epidemiology (J.T.G., L.A.J.) and Biostatistics (R.A.K.), University of Washington, Seattle; the Center for Health Studies, Group Health Cooperative, Seattle (L.A.J.); Miriam Hospital, Providence, R.I. (A.F.P.); LDS Hospital, Salt Lake City (J.B.M.); Saint Louis University Medical Center, St. Louis (J.D.C.); University of Alabama, Birmingham (W.J.R.); Wake Forest University School of Medicine, Winston-Salem, N.C. (J.R.C.); Axio Research, Seattle (S.L.B.); National Heart, Lung, and Blood Institute, Bethesda, Md. (E.S.); and Pfizer, New York (C.K.).

Address reprint requests to Dr. Grayston at the Department of Epidemiology, Box 357236, University of Washington, Seattle, WA 98195.

Full Text of this Article

Related Letters:

Chlamydia pneumoniae and Acute Coronary Syndrome
Wong B. Y.L., Gnarpe J., Mitchell W. M., Stratton C. W., Frothingham R., Paul M., Fraser A., Leibovici L., Grayston J. T., Cannon C. P., the ACES Investigators , the PROVE IT–TIMI 22 Investigators
Extract | Full Text | PDF  
N Engl J Med 2005; 353:525-528, Aug 4, 2005. Correspondence

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