Effect of azithromycin treatment on endothelial function in patients with coronary artery disease and evidence of Chlamydia pneumoniae infection

• Published in: Circulation (New York, N.Y.) N.Y.), 2002-03, Vol.105 (11), p.1298-1303
• Main Authors: PARCHURE, Nikhil, ZOURIDAKIS, Emmanouil G, KASKI, Juan Carlos
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antibodies, Bacterial - blood; Antibodies, Bacterial - drug effects; Azithromycin - therapeutic use; Biological and medical sciences; Biomarkers - blood; Blood Flow Velocity - drug effects; Brachial Artery - diagnostic imaging; Brachial Artery - drug effects; Brachial Artery - physiopathology; C-Reactive Protein - analysis; Chlamydophila Infections - blood; Chlamydophila Infections - complications; Chlamydophila Infections - drug therapy; Coronary Artery Disease - blood; Coronary Artery Disease - complications; Coronary Artery Disease - physiopathology; Double-Blind Method; E-Selectin - blood; Endothelium, Vascular - drug effects; Endothelium, Vascular - physiopathology; Humans; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Prospective Studies; Serologic Tests; Treatment Outcome; Ultrasonography; Vascular Patency - drug effects; Vasodilation - drug effects; von Willebrand Factor - analysis
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/hc1102.105649

It has been suggested that infection with Chlamydia pneumoniae(CPn) can trigger inflammatory mechanisms that may in turn impair vascular endothelial function. The aim of the present study was to assess whether treatment with the macrolide antibiotic azithromycin improves endothelial function in patients with coronary artery disease and antibodies positive to CPn. We carried out a randomized, prospective, double-blind, placebo-controlled trial in 40 male patients (mean age, 55+/-9 years) with documented coronary artery disease and positive CPn-IgG antibody titers. After baseline evaluation, patients were randomized to receive either azithromycin or placebo for 5 weeks. Flow-mediated dilation (FMD) of the brachial artery and E-selectin, von Willebrand factor, and C-reactive protein (CRP) levels were assessed at study entry and at the end of the treatment period. Our results showed that patients who received azithromycin had a significant improvement in FMD (mean change, 2.1+/-1.1%; P