Effect of clarithromycin on inflammatory markers in patients with atherosclerosis.
Atherosclerosis can to a certain extent be regarded as an inflammatory disease. Also, inflammatory markers may provide information about cardiovascular risk. Whether macrolide antibiotics, especially clarithromycin, have an anti-inflammatory effect in patients with atherosclerosis is not exactly known. To study this phenomenon, a placebo-controlled, randomized, double-blind study was performed. A total of 231 patients with documented coronary artery disease received a daily dose of either 500 mg of slow-release clarithromycin or placebo until the day of surgery. Levels of inflammatory markers (C-reactive protein, interleukin-2 receptor [IL-2R], IL-6, IL-8, and tumor necrosis factor alpha) were assessed during the preoperative outpatient visit, on the day of surgery, and 8 weeks after surgery. Also, changes in the levels of inflammatory markers between visits were determined by delta calculations. Baseline patient characteristics were balanced between the two treatment groups: the average age was 66 years (standard deviation [SD] = 9.0), 79% of the patients were male, and the average number of tablets used was 16 (SD = 9.3). The inflammatory markers of the groups as well as the delta calculations were not significantly changed. Treatment with clarithromycin did not influence the inflammatory markers in patients with atherosclerosis.
Berg
Hans F
HF
Department of Clinical Microbiology and Infectious Diseases, St. Elisabeth Hospital, Tilburg, The Netherlands. h.berg@elisabeth.nl
Maraha
Boulos
B
Scheffer
Gert-Jan
GJ
Peeters
Marcel F
MF
Kluytmans
Jan A J W
JA
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015415:Biomarkers; D002097:C-Reactive Protein / Q000032:analysis; D017291:Clarithromycin / Q000627:therapeutic use*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015375:Receptors, Interleukin-2 / Q000097:blood; D017211:Treatment Failure; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D000894:Anti-Inflammatory Agents, Non-Steroidal; D015415:Biomarkers; D015850:Interleukin-6; D016209:Interleukin-8; D015375:Receptors, Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein; D017291:Clarithromycin