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Am Heart J. 2003 May;145(5):E20.

Antibiotics in primary prevention of myocardial infarction among elderly patients with hypertension.

Author information

1
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada. paul.brassard@clinepi.mcgill.ca

Abstract

BACKGROUND:

Given the premise that certain bacteria (such as Chlamydia pneumoniae) may play a role in the etiology of atherosclerosis, subjects treated with antibiotics that have antibacterial activity against C pneumoniae may be at lower risk for the development of an acute myocardial infarction (MI) than untreated subjects.

METHODS:

A case-control design, nested within a cohort of 29,937 elderly subjects in whom antihypertensive therapy was initiated (1982-1995) was used, in which each subject who was hospitalized with a primary discharge diagnosis of MI between 1987 and 1995 (n = 1047) was matched on calendar time to 5 randomly selected control subjects for exposure contrasts. Conditional logistic regression analyses were conducted to adjust for predisposing factors for MI.

RESULTS:

Although no clear consistent effect of antibiotics use was found in relation to MI, a trend was observed for a decreased risk of acute MI in patients receiving a prescription for antichlamydial antibiotics in the preceding 3 months (odds ratio 0.68, 95% CI 0.46-1.00). Antibiotics without antichlamydial activity showed no benefit in MI risk.

CONCLUSION:

The beneficial effect of certain antichlamydial antibiotics in reducing the risk of MI cannot be excluded on the basis of this representative cohort of elderly patients in a routine clinical care setting. Larger prospective studies are required to confirm the usefulness of antibiotics in the primary prevention of MI.

PMID:
12766754
DOI:
10.1016/S0002-8703(03)00087-5
[Indexed for MEDLINE]

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