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Title: Antibiotics Post Acute Coronary Syndromes Reduces Risk Of Second Attacks: Presented at ESC

"Antibiotics Post Acute Coronary Syndromes Reduces Risk Of Second Attacks: Presented at ESC"

By Ed Susman Special to DG News STOCKHOLM, SWEDEN -- September 3, 2001 -- Patients who receive antibiotic therapy with either amoxicillin or azithromycin after experiencing acute coronary syndromes reduce second attacks by 40 percent, say researchers. "We have shown that giving certain antibiotics to patients immediately after a heart attack or episode of angina reduces the number of subsequent attacks over the following year," said Juan Carols Kaski, MD, of St. George's Hospital Medical School, London, England. These findings were presented at the 23rd Congress of the European Society of Cardiology. "Given that up to half of all deaths in the general adult population are related to coronary heart disease, this could be an important step in improving treatment in the future," he said. Dr. Kaski enrolled 324 patients from four hospitals in south London in his study, STAMINA (South Thames trial of Antibiotics in Myocardial INfarction and unstable Angina). The patients had been admitted due to a heart attack or a severe bout of angina. All the patients received standard treatment and were then randomized into three groups: one received a therapy that included azithromycin, metronidazole and omeprazole; one was given a regimen of amoxicillin, metronidazole and omeprazole and the third group received placebo. After a year, Dr. Kaski found no significant differences between the two groups taking antibiotics, but those patients did have a relative risk reduction of 40 percent in new attacks. "The benefit of taking antibiotics for the heart is one that have been much studied in recent years," Dr. Kaski said, "but this is the first trial to show that they may be helpful immediately after a heart attack." He said that researchers were attempting to determine that, if they were able to prevent infections caused by microorganisms, they might be able to prevent or slow the progression of atherosclerosis, believed to be a result of the same inflammatory processes that occur with infections. The antibiotics selected by Dr. Kaski's team was aimed at controlling infection by Chlamydia pneumoniae and Helicobacter pylori, both of which have been suggested as causes of atherosclerosis in other studies. "To our surprise," Dr. Kaski reported, "the antibiotics produced their beneficial effect whether or not the patient was a carrier of one or the other or both of these infections. It may be that the antibiotics we used were working against a different infection altogether. Our findings need to be confirmed before antibiotics can be used routinely." He said larger clinical trials testing the theory are under way. The study was funded by a grant from the UK National Lottery, through the Digestive Disorders Foundation, London.

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