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Antibiotics ineffective in preventing heart attacks

Based on observational studies, some physicians used these drugs in secondary prevention of cardiovascular disease. Now, two recent large studies say this approach doesn't work.

By Victoria Stagg Elliott, amednews staff. Oct. 4, 2004.

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Much to the dismay of investigators searching for a way to attack the infectious disease process believed to have a role in heart disease, two studies presented in August at the European Society of Cardiology annual congress in Munich concluded that antibiotics were not the way to go.

According to results from the Azithromycin and Coronary Events Study (ACES) and the Pravastatin or Atorvastatin Evaluation and Infection Therapy trial (PROVE-IT), adding antibiotics to the regimen of patients who had already experienced a cardiovascular event did nothing to prevent them from having another one.

"Taken together, these studies offer the final word that the antibiotic concept doesn't work," said Christopher Cannon, MD, PROVE-IT's principal investigator and a cardiologist at Brigham and Women's Hospital in Boston.

Various bacteria and viruses have long been implicated in heart disease development, with Chlamydia pneumoniae as the favorite target. Several small observational studies have suggested that antibiotics may be a way to interrupt this process, and some physicians even began to include antibiotics in their secondary prevention strategies.

"There was a small percentage who had been using it, but I think they need to stop doing that now," said J. Thomas Grayston, MD, principal investigator of the ACES trial and professor emeritus of epidemiology at the University of Washington in Seattle.

Researchers say the good news is that it is likely that no harm occurred by prescribing these medications because in the study, patients experienced a very low rate of side effects.