title: Excess sudden cardiac deaths after short-term clarithromycin administration in the CLARICOR trial: why is this so, and why are statins protective?
abstract: OBJECTIVE
  To elucidate potential mechanisms for the clarithromycin-induced excess mortality observed in the CLARICOR trial during 2.6 year follow-up of patients with stable coronary artery disease.
  
  
  METHODS
  Cox analyses using out-of-hospital death as a proxy for sudden death compared to in-hospital (nonsudden) death.
  
  
  RESULTS
  In 100 of 189 (53%) cardiovascular (CV) deaths in which it was possible to examine the question, there was a strong association between place of death and the classification of CV death as sudden or not-sudden. The excess mortality in the clarithromycin group was confined to sudden CV death in patients not on statins at trial entry (HR: 2.61, 95% CI: 1.69-4.05, p < 0.0005). Other categories of deaths showed no marked drug-placebo difference.
  
  
  CONCLUSIONS
  Short-term clarithromycin administration was significantly associated with increased risk of sudden CV death in stable coronary heart disease patients not using statins.
authors: Rigshospitalet, Copenhagen University Hospital and Institute of Preventive Medicine, The Copenhagen Trial Unit, Center for Clinical Intervention Research, Copenhagen, Denmark.
authors: Per
authors: P
authors: Winkel
authors: Jørgen
authors: J
authors: Hilden
authors: Jørgen
authors: J
authors: Fischer Hansen
authors: Per
authors: P
authors: Hildebrandt
authors: Jens
authors: J
authors: Kastrup
authors: Hans Jørn
authors: HJ
authors: Kolmos
authors: Erik
authors: E
authors: Kjøller
authors: Christian M
authors: CM
authors: Jespersen
authors: Christian
authors: C
authors: Gluud
authors: Gorm Boje
authors: GB
authors: Jensen
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D017291:Clarithromycin / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000401:mortality; D016757:Death, Sudden, Cardiac / Q000209:etiology* / Q000517:prevention & control; D003718:Denmark / Q000453:epidemiology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic
chemical_list: D000900:Anti-Bacterial Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017291:Clarithromycin