Effects of Antibiotic Therapy on Outcomes of Patients With Coronary Artery Disease: A Meta-analysis of Randomized Controlled Trials

Andraws, Richard; Berger, Jeffrey S.; Brown, David L.

doi:10.1001/jama.293.21.2641

Cited by 235Atherosclerosis and Cardiovascular DiseasesLipoproteins and Cardiovascular HealthCardiac Health and Mental Health

Effects of Antibiotic Therapy on Outcomes of Patients With Coronary Artery Disease: A Meta-analysis of Randomized Controlled Trials

Andraws, Richard, Berger, Jeffrey S., Brown, David L.·2005·JAMA

DOI 10.1001/jama.293.21.2641

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Abstract

CONTEXT: Although Chlamydia pneumoniae infection has been associated with the initiation and progression of atherosclerosis, results of clinical trials investigating antichlamydial antibiotics as adjuncts to standard therapy in patients with coronary artery disease (CAD) have been inconsistent. OBJECTIVE: To conduct a meta-analysis of clinical trials of antichlamydial antibiotic therapy in patients with CAD. DATA SOURCES: The MEDLINE and Cochrane Central Register of Controlled Trials databases were searched from 1966 to April 2005 for English-language trials of antibiotic therapy in patients with CAD. Bibliographies of retrieved articles were searched for further studies. Presentations at major scientific meetings (2003-2004) were also reviewed. Search terms included antibacterial agents, myocardial infarction, unstable angina, and coronary arteriosclerosis. STUDY SELECTION: Eligible studies were prospective, randomized, placebo-controlled trials of antichlamydial antibiotic therapy in patients with CAD that reported all-cause mortality, myocardial infarction, or unstable angina. Of the 110 potentially relevant articles identified, 11 reports enrolling 19,217 patients were included. DATA EXTRACTION: Included studies were reviewed to determine the number of patients randomized, mean duration of follow-up, and end points. End points of interest included all-cause mortality, myocardial infarction (MI), and a combined end point of MI and unstable angina. DATA SYNTHESIS: Event rates were combined using a random-effects model. Antibiotic therapy had no impact on all-cause mortality among treated vs untreated patients (4.7% vs 4.6%; odds ratio [OR], 1.02; 95% confidence interval [CI], 0.89-1.16; P = .83), on the rates of MI (5.0% vs 5.4%; OR, 0.92; 95% CI, 0.81-1.04; P = .19), or on the combined end point of MI and unstable angina (9.2% vs 9.6%; OR, 0.91; 95% CI, 0.76-1.07; P = .25). CONCLUSION: Evidence available to date does not demonstrate an overall benefit of antibiotic therapy in reducing mortality or cardiovascular events in patients with CAD.

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From Akkermansia Muciniphila Protects Against Atherosclerosis by Preventing Metabolic Endotoxemia-Induced Inflammation in Apoe −/− Mice (2016) · cites this paper as [16]
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From Akkermansia Muciniphila Protects Against Atherosclerosis by Preventing Metabolic Endotoxemia-Induced Inflammation in Apoe −/− Mice (2016) · cites this paper as [16]

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Authors: Andraws, R., Berger, J. S., & Brown, D. L.
Affiliations: Mount Sinai Beth Israel (US)
ORCID: Berger, Jeffrey S.
Brown, David L.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 2005-06-01
Volume: 293
Issue: 21
Pages: 2641
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.293.21.2641
OpenAlex: W1966041159
Cited by: 235
References: 43
Citations by year: 2026: 3 · 2025: 9 · 2024: 3 · 2023: 8 · 2022: 7 · 2021: 7 · 2020: 11 · 2019: 5 · 2018: 9 · 2017: 13 · 2016: 10 · 2015: 15 · 2014: 18 · 2013: 13 · 2012: 19
FWCI: 6.79
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Topics: Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords: coronary artery disease, Chlamydia pneumoniae, antibiotic therapy, myocardial infarction, unstable angina, all-cause mortality, cardiovascular events, atherosclerosis
MeSH terms: Angina, Unstable, Anti-Bacterial Agents, Coronary Artery Disease, Humans, Myocardial Infarction, Survival Analysis, Randomized Controlled Trials as Topic, Chlamydophila pneumoniae, Chlamydophila Infections

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Effects of Antibiotic Therapy on Outcomes of Patients With Coronary Artery Disease: A Meta-analysis of Randomized Controlled Trials

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