Treatment of
            <i>Helicobacter pylori</i>
            and
            <i>Chlamydia pneumoniae</i>
            Infections Decreases Fibrinogen Plasma Level in Patients With Ischemic Heart Disease

Torgano, Giuseppe; Cosentini, Roberto; Mandelli, C.; Perondi, R; Blasi, Francesco; Bertinieri, G.; Tien, Tu Van; Ceriani, Giuliana; Tarsia, Paolo; Arosio, Cristina; Ranzi, M. L.

doi:10.1161/01.cir.99.12.1555

Cited by 68 publications

(29 citation statements)

References 28 publications

(26 reference statements)

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“…Therefore, we cannot discount the possibility that the treatment was acting on C pneumoniae, which was not detected because of insufficient statistical power. In the Torgano study, 14 it was found that treatment was more effective in lowering fibrinogen in the group with both H pylori and C pneumoniae infections. However, a comparison group of patients without infection was not included, which may explain the different findings.…”

Section: Discussionmentioning

confidence: 97%

“…It is also established that single measurements of these variables are predictors of future events and that their link to the inflammatory response is well documented. 13 Of importance, Torgano et al 14 had previously shown that treatment directed against H pylori and C pneumoniae reduces fibrinogen levels in patients with chronic CHD.…”

Section: Discussionmentioning

confidence: 99%

“…31,32 Lansoprazole has been reported to suppress activation on peripheral blood mononuclear cells, 31 whereas omeprazole increases both the number of activated HLA-DR T cells and the expression of activation makers on blood monocytes. 32 The study by Torgano et al, 14 who used a similar regimen against H pylori and clarithromycin to treat C pneumoniae infection, is important in this context. The effect of treatment on fibrinogen was similar in subjects with either C pneumoniae or H pylori treated with clarithromycin alone or clarithromycin as part of a triple regimen including omeprazole, suggesting no additional benefit from this agent.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Treatment for Chlamydia pneumoniae and Helicobacter pylori on Markers of Inflammation and Cardiac Events in Patients With Acute Coronary Syndromes

et al. 2002

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Background-Infection with Helicobacter pylori and Chlamydia pneumoniae is associated with coronary heart disease.We conducted an intervention study using antibiotics against these bacteria in patients with acute coronary syndromes to determine whether antibiotics reduce inflammatory markers and adverse cardiac events. Methods and Results-Patients (nϭ325) admitted with acute myocardial infarction or unstable angina (acute coronary syndromes) were randomized to receive a 1-week course of 1 of 3 treatment regimens: (1) placebo; (2) amoxicillin (500 mg twice daily), metronidazole (400 mg twice daily), and omeprazole (20 mg twice daily); or (3) azithromycin (500 mg once daily), metronidazole (400 mg twice daily), and omeprazole (20 mg twice daily). Serum fibrinogen, white cell count, and high-sensitivity C-reactive protein were measured at study entry and at 1, 3, and 12 months during follow-up. Cardiac death and readmission with acute coronary syndrome were considered clinical end points. Patients were followed for 1 year. C-reactive protein levels were reduced (Pϭ0.03) in unstable angina patients receiving amoxicillin, and fibrinogen was reduced in both patient groups receiving antibiotics (Pϭ0.06). There were 17 cardiac deaths and 71 readmissions with acute coronary syndrome. No difference in frequency or timing of end points was observed between the 2 antibiotic groups. At 12 weeks, there was a 36% reduction in all end points in patients receiving antibiotics compared with placebo (Pϭ0.02). This reduction persisted during the 1-year follow-up. Neither C pneumoniae nor H pylori antibody status was significantly related to response to treatment. Conclusions-Antibiotic treatment significantly reduced adverse cardiac events in patients with acute coronary syndromes, but the effect was independent of H pylori or C pneumoniae seropositivity.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Effect of Treatment for Chlamydia pneumoniae and Helicobacter pylori on Markers of Inflammation and Cardiac Events in Patients With Acute Coronary Syndromes

et al. 2002

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“…Based on examinations of vascular specimens, C pneumoniae were detected in atherosclerotic plaques using immunohistochemical and molecular methods. Serum immunoglobulins recognizing C pneumoniae were used in studies investigating clinical end points [7][8][9][10] ; however, it is still controversial whether IgG or IgA represents a better marker for persistent endovascular infection. The population selected for the present study had markedly elevated serum concentrations of IgG (median, 1:256) and IgA (median, 1:64).…”

Section: Study Strengths and Limitationsmentioning

confidence: 99%

“…9 In an additional study, antibiotic treatment induced a decrease of plasma fibrinogen in C pneumoniae seropositive patients suffering from coronary heart disease. 10 In a recent study, patients with coronary stenting received roxithromycin or placebo for 28 days. Antibiotic treatment revealed no beneficial effect for patients with negative or moderately elevated IgG titers but a preventive effect on coronary restenosis for patients with IgG titers against C pneumoniae of 1:128 or greater.…”

mentioning

confidence: 99%

Roxithromycin Treatment Prevents Progression of Peripheral Arterial Occlusive Disease in Chlamydia pneumoniae Seropositive Men

et al. 2002

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Background-Evidence has been provided that the atherosclerotic process may be associated with chronic infection withChlamydia pneumoniae. The effect of antibiotic treatment on peripheral arterial occlusive disease has not been investigated yet. Methods and Results-Forty C pneumoniae seropositive men suffering from peripheral arterial occlusive disease were randomly assigned to receive either roxithromycin (300 mg daily) or placebo for 28 days. During the 2.7-year follow-up, the number of invasive revascularizations per patient, the walking distance before intervention (in patients without intervention at study end), and the change of carotid plaque size were assessed. Five interventions were performed on 4 patients (20%) in the roxithromycin group, and 29 interventions were performed on 9 patients (45%) in the placebo group. Limitation of walking distance to 200 m or less was observed in 4 patients (20%) in the roxithromycin group and in 13 patients (65%) in the placebo group. The effect of macrolide treatment on the number of interventions per patient and on preinterventional walking distance was significant. Possible confounding variables such as classical vascular risk factors were excluded by multiple regression analyses. Carotid plaque areas monitored over 6 months decreased in the roxithromycin group (mean relative value, 94.4%) but remained constant in the placebo group (100.2%). Regression of carotid plaque size observed in roxithromycin-treated patients was significant for soft plaques. Conclusions-This study indicates that macrolide treatment for 1 month is effective in preventing C pneumoniae seropositive men from progression of lower limb atherosclerosis for several years.

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Antibiotics for the Secondary Prevention of Ischemic Heart Disease

Wells¹,

Mainous²,

Dickerson³

2004

Arch Intern Med

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Treatment of Helicobacter pylori and Chlamydia pneumoniae Infections Decreases Fibrinogen Plasma Level in Patients With Ischemic Heart Disease

Abstract: Our data suggest that a short, safe, and effective course of antibiotic therapy might be suggested as a means of interacting with an "emerging" risk factor.

Cited by 68 publications

References 28 publications

Effect of Treatment for Chlamydia pneumoniae and Helicobacter pylori on Markers of Inflammation and Cardiac Events in Patients With Acute Coronary Syndromes

Effect of Treatment for Chlamydia pneumoniae and Helicobacter pylori on Markers of Inflammation and Cardiac Events in Patients With Acute Coronary Syndromes

Roxithromycin Treatment Prevents Progression of Peripheral Arterial Occlusive Disease in Chlamydia pneumoniae Seropositive Men

Antibiotics for the Secondary Prevention of Ischemic Heart Disease

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