Literature DB >> 21447948

Excess sudden cardiac deaths after short-term clarithromycin administration in the CLARICOR trial: why is this so, and why are statins protective?

Per Winkel1, Jørgen Hilden, Jørgen Fischer Hansen, Per Hildebrandt, Jens Kastrup, Hans Jørn Kolmos, Erik Kjøller, Christian M Jespersen, Christian Gluud, Gorm Boje Jensen.   

Abstract

OBJECTIVES: To elucidate potential mechanisms for the clarithromycin-induced excess mortality observed in the CLARICOR trial during 2.6 year follow-up of patients with stable coronary artery disease.
METHODS: Cox analyses using out-of-hospital death as a proxy for sudden death compared to in-hospital (nonsudden) death. RESULT: In 100 of 189 (53%) cardiovascular (CV) deaths in which it was possible to examine the question, there was a strong association between place of death and the classification of CV death as sudden or not-sudden. The excess mortality in the clarithromycin group was confined to sudden CV death in patients not on statins at trial entry (HR: 2.61, 95% CI: 1.69-4.05, p < 0.0005). Other categories of deaths showed no marked drug-placebo difference.
CONCLUSIONS: Short-term clarithromycin administration was significantly associated with increased risk of sudden CV death in stable coronary heart disease patients not using statins.
Copyright © 2011 S. Karger AG, Basel.

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Year:  2011        PMID: 21447948     DOI: 10.1159/000324533

Source DB:  PubMed          Journal:  Cardiology        ISSN: 0008-6312            Impact factor:   1.869


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