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Cited by 335

The DOI matches its Crossref record; 34 of the 34 references it cites were found in a registry or an index.

Randomized Secondary Prevention Trial of Azithromycin in Patients With Coronary Artery Disease and Serological Evidence for Chlamydia pneumoniae Infection: The Azithromycin in Coronary Artery Disease: Elimination of Myocardial Infection with Chlamydia (ACADEMIC) Study

Anderson, Jeffrey L., Muhlestein, Joseph B., Carlquist, John, Allen, Ann, Trehan, Sanjeev, Nielson, Cindy, Hall, Staci, Brady, John, Egger, Marlene, Horne, Benjamin, Lim, Tobin·1999·Circulation
DOI 10.1161/01.cir.99.12.1540
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Abstract

Background — Chlamydia pneumoniae commonly causes respiratory infection, is vasotropic, causes atherosclerosis in animal models, and has been found in human atheromas. Whether it plays a causal role in clinical coronary artery disease (CAD) and is amenable to antibiotic therapy is uncertain. Methods and Results —CAD patients (n=302) who had a seropositive reaction to C pneumoniae (IgG titers ≥1:16) were randomized to receive placebo or azithromycin, 500 mg/d for 3 days, then 500 mg/wk for 3 months. Circulating markers of inflammation (C-reactive protein [CRP], interleukin [IL]-1, IL-6, and tumor necrosis factor [TNF]-α), C pneumoniae antibody titers, and cardiovascular events were assessed at 3 and 6 months. Treatment groups were balanced, with age averaging 64 (SD=10) years; 89% of the patients were male. Azithromycin reduced a global rank sum score of the 4 inflammatory markers at 6 (but not 3) months ( P =0.011) as well as the mean global rank sum change score: 531 (SD=201) for active drug and 587 (SD=190) for placebo ( P =0.027). Specifically, change-score ranks were significantly lower for CRP ( P =0.011) and IL-6 ( P =0.043). Antibody titers were unchanged, and number of clinical cardiovascular events at 6 months did not differ by therapy (9 for active drug, 7 for placebo). Azithromycin decreased infections requiring antibiotics (1 versus 12 at 3 months, P =0.002) but caused more mild, primarily gastrointestinal, adverse effects (36 versus 17, P =0.003). Conclusions —In CAD patients positive for C pneumoniae antibodies, global tests of 4 markers of inflammation improved at 6 months with azithromycin. However, unlike another smaller study, no differences in antibody titers and clinical events were observed. Longer-term and larger studies of antichlamydial therapy are indicated.

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Metadata

Authors
Anderson, J. L., Muhlestein, J. B., Carlquist, J., Allen, A., Trehan, S., Nielson, C., Hall, S., Brady, J., Egger, M., Horne, B., & Lim, T.
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1999-03-30
Volume
99
Issue
12
Pages
1540-1547
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.99.12.1540
OpenAlex
W1993298922
Cited by
335
References
34
FWCI
18.91
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Randomized Secondary Prevention Trial of Azithromycin in Patients With Coronary Artery Disease and Serological Evidence for Chlamydia pneumoniae Infection: The Azithromycin in Coronary Artery Disease: Elimination of Myocardial Infection with Chlamydia (ACADEMIC) Study. https://app.cochat.ai/papers/10.1161/01.cir.99.12.1540
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Anderson, J. L., Muhlestein, J. B., Carlquist, J., Allen, A., Trehan, S., Nielson, C., Hall, S., Brady, J., Egger, M., Horne, B., & Lim, T. (1999). Randomized Secondary Prevention Trial of Azithromycin in Patients With Coronary Artery Disease and Serological Evidence for Chlamydia pneumoniae Infection: The Azithromycin in Coronary Artery Disease: Elimination of Myocardial Infection with Chlamydia (ACADEMIC) Study. Circulation. https://doi.org/10.1161/01.cir.99.12.1540

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.