BACKGROUND: Results of studies concerning prevention of cardiovascular disease by treatment with macrolide antibiotics targeting C. pneumoniae infection are still controversial. This study describes the results of different tests for infection with C. pneumoniae as well as the effect of treatment with roxithromycin in patients with acute myocardial infarction (AMI) in relation to their serostatus against C. pneumoniae. METHODS: We analysed blood of 160 patients who came from the ANTIBIOtic therapy after an AMI ( ANTIBIO-) study, a prospective, randomised, placebo-controlled, double-blind study to investigate the effect of roxithromycin 300 mg/OD for 6 weeks in patients with an AMI. Anti- ChlamydiaIgG-, IgA-, and IgM-antibodies of these patients were analysed by means of different test systems. RESULTS: There was a good correlation between the two IgG and IgA methods (r = 0.900, p < 0.001 and r = 0.878, p < 0.001, respectively), but marked differences in the prevalence of positive tests. This resulted in only moderate concordance values, as expressed by the Kappa coefficients, for IgG kappa = 0.611 (95% CI = 0.498-0.724, p < 0.001) and for IgA kappa = 0.431 (95% CI: 0.322-0.540, p < 0.001). No significant association between positive C. pneumonia titers and the combined clinical endpoint during the 12 month follow-up could be found. In all test systems used, patients with positive anti- C. pneumoniae titers did not benefit from roxithromycin therapy (p = ns). CONCLUSION: Depending on the test system used, there are large differences in the prevalence of anti- C. pneumoniae seropositive patients. Clinical events during the 12 month follow-up after AMI did not depend on serostatus against C. pneumoniae and treatment with roxithromycin did not influence these events, independently of the serostatus against C. pneumoniae. However, the power of this subgroup analysis was low to detect small but significant differences.
RCT Entities:
BACKGROUND: Results of studies concerning prevention of cardiovascular disease by treatment with macrolide antibiotics targeting C. pneumoniae infection are still controversial. This study describes the results of different tests for infection with C. pneumoniae as well as the effect of treatment with roxithromycin in patients with acute myocardial infarction (AMI) in relation to their serostatus against C. pneumoniae. METHODS: We analysed blood of 160 patients who came from the ANTIBIOtic therapy after an AMI ( ANTIBIO-) study, a prospective, randomised, placebo-controlled, double-blind study to investigate the effect of roxithromycin 300 mg/OD for 6 weeks in patients with an AMI. Anti- Chlamydia IgG-, IgA-, and IgM-antibodies of these patients were analysed by means of different test systems. RESULTS: There was a good correlation between the two IgG and IgA methods (r = 0.900, p < 0.001 and r = 0.878, p < 0.001, respectively), but marked differences in the prevalence of positive tests. This resulted in only moderate concordance values, as expressed by the Kappa coefficients, for IgG kappa = 0.611 (95% CI = 0.498-0.724, p < 0.001) and for IgA kappa = 0.431 (95% CI: 0.322-0.540, p < 0.001). No significant association between positive C. pneumonia titers and the combined clinical endpoint during the 12 month follow-up could be found. In all test systems used, patients with positive anti- C. pneumoniae titers did not benefit from roxithromycin therapy (p = ns). CONCLUSION: Depending on the test system used, there are large differences in the prevalence of anti- C. pneumoniae seropositive patients. Clinical events during the 12 month follow-up after AMI did not depend on serostatus against C. pneumoniae and treatment with roxithromycin did not influence these events, independently of the serostatus against C. pneumoniae. However, the power of this subgroup analysis was low to detect small but significant differences.
Authors: J B Muhlestein; J L Anderson; J F Carlquist; K Salunkhe; B D Horne; R R Pearson; T J Bunch; A Allen; S Trehan; C Nielson Journal: Circulation Date: 2000-10-10 Impact factor: 29.690
Authors: P Saikku; M Leinonen; K Mattila; M R Ekman; M S Nieminen; P H Mäkelä; J K Huttunen; V Valtonen Journal: Lancet Date: 1988-10-29 Impact factor: 79.321
Authors: J Gieffers; H Füllgraf; J Jahn; M Klinger; K Dalhoff; H A Katus; W Solbach; M Maass Journal: Circulation Date: 2001-01-23 Impact factor: 29.690
Authors: J L Anderson; J B Muhlestein; J Carlquist; A Allen; S Trehan; C Nielson; S Hall; J Brady; M Egger; B Horne; T Lim Journal: Circulation Date: 1999-03-30 Impact factor: 29.690
Authors: Juha Sinisalo; Kimmo Mattila; Ville Valtonen; Olli Anttonen; Jukka Juvonen; John Melin; Helena Vuorinen-Markkola; Markku S Nieminen Journal: Circulation Date: 2002-04-02 Impact factor: 29.690
Authors: Adam F M Stone; Michael A Mendall; Juan-Carlos Kaski; Tracey M Edger; Paul Risley; Jan Poloniecki; A John Camm; Timothy C Northfield Journal: Circulation Date: 2002-09-03 Impact factor: 29.690
Authors: Jacek Budzyński; Marek Koziński; Maria Kłopocka; Julia Maria Kubica; Jacek Kubica Journal: Clin Res Cardiol Date: 2014-05-10 Impact factor: 5.460
Authors: Malene Plejdrup Hansen; Anna M Scott; Amanda McCullough; Sarah Thorning; Jeffrey K Aronson; Elaine M Beller; Paul P Glasziou; Tammy C Hoffmann; Justin Clark; Chris B Del Mar Journal: Cochrane Database Syst Rev Date: 2019-01-18