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Original ArticleOpen Access
Roxithromycin in Prevention of Acute Coronary Syndrome Associated with Chlamydia pneumoniae Infection: A Randomized Placebo Controlled Trial
Leowattana W 
,
Mahanonda N ,
Bhuripanyo K ,
Samranthin M ,
Singhaviranon L ,
Pokum S ,
Akaniroj S
,
Mahanonda N ,
Bhuripanyo K ,
Samranthin M ,
Singhaviranon L ,
Pokum S ,
Akaniroj S NITHI MAHANONDA, M.D.**,
MANOON SAMRANTHIN, M.D.**,
SASIKANT POKUM, B.Sc.*,
The role of
Chlamydia pneumoniae
infection in precipitating acute coronary syndrome
(ACS) is unclear. Some studies have indicated that intervention with macrolide antibiotics might
reduce coronary events in patients with ACS. A double blind, randomized, placebo-control trial
was conducted on 84 ACS patients. Patients were randomized to 30 days of treatment with roxi-
thromycin (150 mg, twice daily) or matching placebo. The follow-up period was 90 days, and the
primary clinical end point included cardiovascular death, unplanned revascularization and recurrent
angina/MI. Anti-C.
pneumoniae
lgG positive in 24 of 43 (55.8%) patients in the roxithromycin
group and 23 of 41 (56.1 %) patients in the placebo group. Anti-C.
pneumoniae
IgA positive in
20 of 43 (46.5%) patients in the roxithromycin group and 13 of 41 (31.7%) patients in the placebo
group. Thirty-three cardiac events occurred (2 cardiovascular deaths, 9 CABO, 12 PTCA and 10
recurrent angina/MI) with 17 events in the roxithromycin group and 16 events in the placebo
group. There was no significant difference of cardiac events between the roxithromycin and placebo
groups. The present study suggests that antibiotic therapy with roxithromycin is not associated
with reduction of cardiac events as reported by other investigators. However, therapeutic inter-
ventions may need to be specifically targeted to a group of patients who are confirmed with chronic
C. pneumoniae
infection.
Key word :
Chlamydia pneumoniae,
Randomized Placebo Control, Roxithromycin, Acute Coro-
nary Syndrome
MANOON SAMRANTHIN, M.D.**,
SASIKANT POKUM, B.Sc.*,
The role of
Chlamydia pneumoniae
infection in precipitating acute coronary syndrome
(ACS) is unclear. Some studies have indicated that intervention with macrolide antibiotics might
reduce coronary events in patients with ACS. A double blind, randomized, placebo-control trial
was conducted on 84 ACS patients. Patients were randomized to 30 days of treatment with roxi-
thromycin (150 mg, twice daily) or matching placebo. The follow-up period was 90 days, and the
primary clinical end point included cardiovascular death, unplanned revascularization and recurrent
angina/MI. Anti-C.
pneumoniae
lgG positive in 24 of 43 (55.8%) patients in the roxithromycin
group and 23 of 41 (56.1 %) patients in the placebo group. Anti-C.
pneumoniae
IgA positive in
20 of 43 (46.5%) patients in the roxithromycin group and 13 of 41 (31.7%) patients in the placebo
group. Thirty-three cardiac events occurred (2 cardiovascular deaths, 9 CABO, 12 PTCA and 10
recurrent angina/MI) with 17 events in the roxithromycin group and 16 events in the placebo
group. There was no significant difference of cardiac events between the roxithromycin and placebo
groups. The present study suggests that antibiotic therapy with roxithromycin is not associated
with reduction of cardiac events as reported by other investigators. However, therapeutic inter-
ventions may need to be specifically targeted to a group of patients who are confirmed with chronic
C. pneumoniae
infection.
Key word :
Chlamydia pneumoniae,
Randomized Placebo Control, Roxithromycin, Acute Coro-
nary Syndrome
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