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Treatment with the antibiotic
azithromycin (Zithromax) may improve blood vessel function in some patients
with coronary artery disease.
UK researchers found that a
5-week course of the antibiotic appeared to boost flow-mediated dilation
in patients' arteries -- a measure of how well the blood vessel lining,
or endothelium, reacts when the body needs more oxygen-rich blood.
All of the 40 male patients
in the study had evidence of Chlamydia pneumoniae bacteria in their blood.
Growing evidence suggests that chronic infection with certain bacteria,
such as the respiratory bug C. pneumoniae, plays a role in the development
of artery blockages and in destabilizing these blockages to help trigger
heart attack and stroke. Because of this, investigators have been studying
whether bacteria-fighting antibiotics could help treat artery disease.
The current findings "clearly
show" that azithromycin can improve blood vessel function in coronary
artery disease patients who carry C. pneumoniae, according to Kaski and
his colleagues.
But whether this benefit will
translate into improvements in patients' artery disease and reduced risks
of heart attack and stroke is far from clear.
Some researchers believe that
chronic, low-grade infection with certain germs contributes to artery
disease by creating an inflammatory response that damages the blood vessel
lining and potentially contributes to artery blockages. In addition, this
inflammation could disturb unstable artery blockages and help trigger
a heart attack or stroke.
In his team's study, half of
the men were randomly assigned to take azithromycin for 5 weeks, while
the other half took an inactive placebo. At the end of the study, the
antibiotic patients showed improved functioning in an artery in the arm,
while there were no significant changes in the placebo patients.
Circulation
February 26, 2002;10.1161/hc1102.105649
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