The inflammatory markers evaluated in the Utah study included C-reactive protein, tumor necrosis factor (TNF) and the interleukins IL-1 and IL-6, molecules secreted by inflammatory cells in the blood vessels and associated with the formation and progression of the fat-laden plaque that characterizes atherosclerosis.
"Lower inflammatory marker levels were evident at six months, but not at three months, which lead researchers to hope that the 'ramping down' of these markers would continue during the 18 remaining months of the study," says Anderson.
"Whether we will see over the full two years a moderate but worthwhile further reduction in the levels of these markers, which are very important signals of inflammation and reduction in the number of cardiovascular events, is unknown," Anderson says.
Thus far, the researchers have found no reduction in the number of heart attacks and other "events" (death; unstable angina, which is chest pain that can not be treated effectively; procedures to restore blood flow such as angioplasty and bypass surgery; or stroke) in the group of individuals receiving azithromycin as compared to those on placebo (an inactive pill). There was also no difference in the quantity of antibodies against Chlamydia observed in the two groups of patients. However, administration of azithromycin substantially reduced the number of infections requiring antibiotics.
"At this point, we don't want to raise wild expectations that heart
disease can be cured with a few doses of antibiotics," Muhlestein emphasizes.
"Clearly, there are a number of other risk factors involved besides infection,
but the established risk factors account for only about half of all cases of
heart disease, so we need to keep looking fo
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Contact: Carole Bullock
caroleb@heart.org
214-706-1279
American Heart Association
30-Mar-1999