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Azithromycin for the secondary prevention of coronary heart disease events: the WIZARD study: a randomized controlled trial.
O'Connor CM, Dunne MW, Pfeffer MA, Muhlestein JB, Yao L, Gupta S, Benner RJ, Fisher MR, Cook TD
JAMA 2003 Sep 17;290(11):1459-66.
abstract (from PubMed)

This large study randomized patients with serological evidence of prior exposure to Chlamydia pneumoniae and a history of myocardial infarction to 12 weeks of weekly azithromycin treatment, in the hope of reducing secondary events.

There was no significant decrease in the subsequent occurence of endpoints, although there was a trend towards benefit of azithromycin, especially in certain subgroups (men, smokers and diabetics in particular).

As the accompanying editorial points out, it is impossible to tell whether the negative result is due to a lack of effect of azithromycin, to an inadequate dosage regimen, or to failure to target a more appropriate sub-group.


Too bad the CRP wasn't measured

September 19, 2003

Since the "inflammatory" theory of atherosclerosis has gained in popularity, particularly with the current interest in CRP determination, it is a pity that no mention is made at all of CRP levels in these patients. Perhaps a subgroup with high CRP might be the most appropriate target for this type of approach.
posted on 2003-09-19 10:12:11 by
Michael Jacobson, MD, MPH

Journal Club copyright Michael Jacobson, MD 1995-2003. Contents may be reproduced for non-commercial purposes, if source is credited. This website is intended as a discussion forum concerning the medical literature, not as a primary source for general medical information. Comments posted here are the responsibility of those posting them, not of this website. Inclusion here does not imply review or approval by this website.