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

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 pati...

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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
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description 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
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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&lt;0.005). In contrast, FMD was not significantly changed in the placebo group (mean change, -0.02+/-0.2%, P=0.64). Azithromycin therapy also resulted in a significant decrease of E-selectin and von Willebrand factor levels. CRP levels were not significantly altered by treatment with either azithromycin or placebo. Beneficial effects of azithromycin treatment were independent from the presence of low (&lt;1:32) or high (&gt; or =1:32) CPn antibody titers. Our findings indicate that treatment with azithromycin has a favorable effect on endothelial function in patients with documented coronary artery disease and evidence of CPn infection irrespective of antibody titer levels. 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Antiinfectious agents. Antiparasitic agents</topic><topic>Antibodies, Bacterial - blood</topic><topic>Antibodies, Bacterial - drug effects</topic><topic>Azithromycin - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Blood Flow Velocity - drug effects</topic><topic>Brachial Artery - diagnostic imaging</topic><topic>Brachial Artery - drug effects</topic><topic>Brachial Artery - physiopathology</topic><topic>C-Reactive Protein - analysis</topic><topic>Chlamydophila Infections - blood</topic><topic>Chlamydophila Infections - complications</topic><topic>Chlamydophila Infections - drug therapy</topic><topic>Coronary Artery Disease - blood</topic><topic>Coronary Artery Disease - complications</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Double-Blind Method</topic><topic>E-Selectin - blood</topic><topic>Endothelium, Vascular - drug effects</topic><topic>Endothelium, Vascular - physiopathology</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Pharmacology. Drug treatments</topic><topic>Prospective Studies</topic><topic>Serologic Tests</topic><topic>Treatment Outcome</topic><topic>Ultrasonography</topic><topic>Vascular Patency - drug effects</topic><topic>Vasodilation - drug effects</topic><topic>von Willebrand Factor - analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>PARCHURE, Nikhil</creatorcontrib><creatorcontrib>ZOURIDAKIS, Emmanouil G</creatorcontrib><creatorcontrib>KASKI, Juan Carlos</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>PARCHURE, Nikhil</au><au>ZOURIDAKIS, Emmanouil G</au><au>KASKI, Juan Carlos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of azithromycin treatment on endothelial function in patients with coronary artery disease and evidence of Chlamydia pneumoniae infection</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2002-03-19</date><risdate>2002</risdate><volume>105</volume><issue>11</issue><spage>1298</spage><epage>1303</epage><pages>1298-1303</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>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&lt;0.005). In contrast, FMD was not significantly changed in the placebo group (mean change, -0.02+/-0.2%, P=0.64). Azithromycin therapy also resulted in a significant decrease of E-selectin and von Willebrand factor levels. CRP levels were not significantly altered by treatment with either azithromycin or placebo. Beneficial effects of azithromycin treatment were independent from the presence of low (&lt;1:32) or high (&gt; or =1:32) CPn antibody titers. Our findings indicate that treatment with azithromycin has a favorable effect on endothelial function in patients with documented coronary artery disease and evidence of CPn infection irrespective of antibody titer levels. Whether these favorable actions of antibiotic treatment will translate into a beneficial effect on atherogenesis and cardiac events needs further investigation.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams &amp; Wilkins</pub><pmid>11901039</pmid><doi>10.1161/hc1102.105649</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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ispartof Circulation (New York, N.Y.), 2002-03, Vol.105 (11), p.1298-1303
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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
title Effect of azithromycin treatment on endothelial function in patients with coronary artery disease and evidence of Chlamydia pneumoniae infection
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