Document Detail


Effects of antibiotic therapy on outcomes of patients with coronary artery disease: a meta-analysis of randomized controlled trials.
MedLine Citation:
PMID:  15928286     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: Although Chlamydia pneumoniae infection has been associated with the initiation and progression of atherosclerosis, results of clinical trials investigating antichlamydial antibiotics as adjuncts to standard therapy in patients with coronary artery disease (CAD) have been inconsistent. OBJECTIVE: To conduct a meta-analysis of clinical trials of antichlamydial antibiotic therapy in patients with CAD. DATA SOURCES: The MEDLINE and Cochrane Central Register of Controlled Trials databases were searched from 1966 to April 2005 for English-language trials of antibiotic therapy in patients with CAD. Bibliographies of retrieved articles were searched for further studies. Presentations at major scientific meetings (2003-2004) were also reviewed. Search terms included antibacterial agents, myocardial infarction, unstable angina, and coronary arteriosclerosis. STUDY SELECTION: Eligible studies were prospective, randomized, placebo-controlled trials of antichlamydial antibiotic therapy in patients with CAD that reported all-cause mortality, myocardial infarction, or unstable angina. Of the 110 potentially relevant articles identified, 11 reports enrolling 19,217 patients were included. DATA EXTRACTION: Included studies were reviewed to determine the number of patients randomized, mean duration of follow-up, and end points. End points of interest included all-cause mortality, myocardial infarction (MI), and a combined end point of MI and unstable angina. DATA SYNTHESIS: Event rates were combined using a random-effects model. Antibiotic therapy had no impact on all-cause mortality among treated vs untreated patients (4.7% vs 4.6%; odds ratio [OR], 1.02; 95% confidence interval [CI], 0.89-1.16; P = .83), on the rates of MI (5.0% vs 5.4%; OR, 0.92; 95% CI, 0.81-1.04; P = .19), or on the combined end point of MI and unstable angina (9.2% vs 9.6%; OR, 0.91; 95% CI, 0.76-1.07; P = .25). CONCLUSION: Evidence available to date does not demonstrate an overall benefit of antibiotic therapy in reducing mortality or cardiovascular events in patients with CAD.
Authors:
Richard Andraws; Jeffrey S Berger; David L Brown
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  293     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2005 Jun 
Date Detail:
Created Date:  2005-06-01     Completed Date:  2005-06-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2641-7     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Medicine, Department of Medicine, Beth Israel Medical Center, New York, NY, USA.
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MeSH Terms
Descriptor/Qualifier:
Angina, Unstable / drug therapy,  microbiology,  mortality
Anti-Bacterial Agents / therapeutic use*
Chlamydophila Infections / drug therapy
Chlamydophila pneumoniae
Coronary Artery Disease / drug therapy*,  microbiology,  mortality
Humans
Myocardial Infarction / drug therapy,  microbiology,  mortality
Randomized Controlled Trials as Topic
Survival Analysis
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

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


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