Document Detail

Azithromycin for the secondary prevention of coronary artery disease: a meta-analysis.
MedLine Citation:
PMID:  17420199     Owner:  NLM     Status:  MEDLINE    
PURPOSE: A meta-analysis of randomized, controlled trials that evaluated the effect of the macrolide antibiotic, azithromycin, on clinical outcomes in patients with coronary artery disease (CAD) was conducted. METHODS: A systematic literature search of MEDLINE, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews was conducted using specific search terms. Randomized, controlled trials comparing azithromycin or placebo in secondary CAD patients with adequately reported data on mortality and clinical cardiac endpoints were included. A random-effects model was used. RESULTS: Six studies (n=13,778) met the inclusion criteria. The trials varied in their design. On meta-analysis, azithromycin resulted in a nonsignificant reduction in mortality versus placebo (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.77-1.09; p=0.31). Four trials reported the rate of nonfatal myocardial infarction (MI). Azithromycin did not have an effect on the rate of nonfatal MI versus placebo (OR, 0.95; 95% CI, 0.80-1.13; p=0.57). Five trials reported rates of hospitalization in which no significant difference was seen with azithromycin versus placebo (OR, 0.97; 95% CI, 0.80-1.17; p=0.76). Six trials were used to evaluate the composite cardiovascular endpoint. Again, no significant benefit was seen with azithromycin versus placebo (OR, 0.93; 95% CI, 0.84-1.03; p=0.218). CONCLUSION: Meta-analysis showed that azithromycin does not appear to reduce the frequency of recurrent cardiac events in patients with CAD. Results from ongoing trials may clarify the role of azithromycin in the secondary prevention of coronary events.
William L Baker; Kimberly A Couch
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists     Volume:  64     ISSN:  1079-2082     ISO Abbreviation:  Am J Health Syst Pharm     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-10     Completed Date:  2007-06-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9503023     Medline TA:  Am J Health Syst Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  830-6     Citation Subset:  IM    
School of Pharmacy, University of Connecticut, Storrs, and Division of Cardiology, Hartford Hospital 06102, USA.
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MeSH Terms
Anti-Bacterial Agents / therapeutic use*
Azithromycin / therapeutic use*
Chlamydophila Infections / drug therapy*
Chlamydophila pneumoniae / drug effects
Coronary Artery Disease / prevention & control*
Models, Statistical
Myocardial Infarction / drug therapy
Randomized Controlled Trials as Topic
Reg. No./Substance:
0/Anti-Bacterial Agents; 83905-01-5/Azithromycin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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