title: Effect of 3 months of antimicrobial treatment with clarithromycin in acute non-q-wave coronary syndrome.
abstract: BACKGROUND
  Coronary artery disease, an inflammatory disease, may be caused by infection. We investigated whether the antibiotic clarithromycin would reduce morbidity and mortality in patients with acute non-Q-wave coronary syndrome.
  
  
  RESULTS
  Altogether, 148 patients with acute non-Q-wave infarction or unstable angina were randomly assigned to receive double-blind treatment with either clarithromycin or placebo for 3 months. The primary end point was a composite of death, myocardial infarction, or unstable angina during treatment; the secondary end point was occurrence of any cardiovascular event during the entire follow-up period (average 555 days, range 138 to 924 days). There was a trend toward fewer patients meeting primary end-point criteria in the clarithromycin group than in the placebo group (11 versus 19 patients, respectively; risk ratio 0.54, 95% CI 0.25 to 1.14; P=0.10). By the end of the entire follow-up, 16 patients in the clarithromycin group and 27 in the placebo group had experienced a cardiovascular event (risk ratio 0.49, 95% CI 0.26 to 0.92; P=0.03).
  
  
  CONCLUSIONS
  Clarithromycin appears to reduce the risk of ischemic cardiovascular events in patients presenting with acute non-Q-wave infarction or unstable angina. No signs of this effect diminishing were observed during follow-up.
authors.affiliation: Helsinki University Central Hospital, Department of Medicine, Division of Cardiology, Finland. juha.sinisalo@hus.fi
authors.forename: Juha
authors.initials: J
authors.lastname: Sinisalo
authors.forename: Kimmo
authors.initials: K
authors.lastname: Mattila
authors.forename: Ville
authors.initials: V
authors.lastname: Valtonen
authors.forename: Olli
authors.initials: O
authors.lastname: Anttonen
authors.forename: Jukka
authors.initials: J
authors.lastname: Juvonen
authors.forename: John
authors.initials: J
authors.lastname: Melin
authors.forename: Helena
authors.initials: H
authors.lastname: Vuorinen-Markkola
authors.forename: Markku S
authors.initials: MS
authors.lastname: Nieminen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004562:Electrocardiography; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D015996:Survival Rate; D013577:Syndrome; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin