Key result
Short-term azithromycin fails to reduce 12-month major cardiovascular events vs placebo in post-PCI ACS patients.
Why the study?
Serological and epidemiological evidence links Chlamydia pneumoniae infection to coronary artery disease, motivating an evaluation of whether azithromycin reduces inflammatory markers and MACE in Korean patients with ACS undergoing PCI.
Does short-term azithromycin treatment reduce inflammatory markers and major adverse cardiac events in Korean patients with acute coronary syndrome undergoing percutaneous coronary intervention?
RCT (n=129)
Placebo-controlled
Randomly selected
Does short-term azithromycin treatment reduce inflammatory markers and major adverse cardiac events in Korean patients with acute coronary syndrome undergoing percutaneous coronary intervention?
Short-term antibiotic therapy with azithromycin does not reduce 12-month major adverse cardiac events in patients with acute coronary syndrome undergoing PCI.
Answers are grounded in this paper and cite their sources.
Azithromycin adds no MACE reduction after PCI in ACS; leaves open longer regimens or targeted subgroups.
Background and Objectives：There is serological and epidemiological evidence of an association between Chlamydia pneumoniae infection and coronary artery disease. We conducted a randomized study using azithromycin treatment in Korean patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) to determine whether azithromycin treatment reduced the inflammatory markers and major adverse cardiac events (MACE). Subjects and Methods：One hundred twenty nine patients were randomly selected to receive 500 mg azithromycin daily for 3 days before and after PCI, followed by 500 mg/week for 2 weeks (Group Ⅰ：64 patients, 43 male, 60.0±10.0 years), or they received a placebo (Group Ⅱ： 65 patients, 45 male, 59.6±10.1 years). Patients were followed up for 12 months. The primary endpoints were cardiac death, recurrent myocardial infarction (MI), target lesion revascularization (TLR) and Non-TLR during the 12-month follow-up. Results： There were no differences between the two groups in baseline characteristics, coronary angiography finding, lesion characteristics, baseline inflammatory markers and baseline antibody titers of Chlamydia pneumoniae, Helicobacter pyroli and Mycoplasma. After the antibiotic treatment, ESR and CRP decreased from 19.6±20.7 mg/dL and 0.75±0.99 mg/dL to 9.36±10.5 mg/dL and 0.22±0.20 mg/dL in group Ⅰ (p=0.002, 0.001 respectively), and from 19.6±21.5 mg/dL, 1.44±2.69 mg/dL to 10.4±10.8 mg/dL, 0.55±1.48 mg/dL in group Ⅱ (p=0.052, <0.0001 respectively). However, there were no significant changes in the serologic markers. MACE developed in 17 (26.6%) out of 64 patients in group Ⅰ with 2 death, 2 MI and 13 TLR. In group Ⅱ, 14 (21.5%) out of 65 patients had MACE with 2 death, 1 MI and 10 TLR during the 12 -month clinical follow-up (p=NS). Conclusion：Short-term treatment with azithromycin does not reduce the major adverse cardiac events in Korean patients with ACS after PCI. (Korean Circulation J 2004;34(8): 743-751)
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Kim et al. (2004) conducted an RCT in Acute coronary syndrome after percutaneous coronary intervention (n=129). Azithromycin vs. Placebo was evaluated on Major adverse cardiac events (cardiac death, recurrent myocardial infarction, target lesion revascularization, and non-target lesion revascularization) (p=NS). Short-term azithromycin treatment did not reduce 12-month major adverse cardiac events compared to placebo in ACS patients after PCI.
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