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Clarithromycin for 2 weeks for stable coronary heart disease: 6-year follow-up of the CLARICOR randomized trial and updated meta-analysis of antibiotics for coronary heart disease
- Source :
- Gluud, C, Als-Nielsen, B, Damgaard, M, Fischer Hansen, J, Hansen, S, Helø, O H, Hildebrandt, P, Hilden, J, Jensen, G B, Kastrup, J, Kolmos, H J, Kjøller, E, Lind, I, Petersen, L & Jespersen, C M 2008, ' Clarithromycin for 2 Weeks for Stable Coronary Heart Disease : 6-Year Follow-Up of the CLARICOR Randomized Trial and Updated Meta-Analysis of Antibiotics for Coronary Heart Disease ', Cardiology, vol. 111, no. 4, pp. 280-287 . https://doi.org/10.1159/000128994
- Publication Year :
- 2007
-
Abstract
- Objectives: We have reported increased 2.6-year mortality in clarithromycin- versus placebo-exposed stable coronary heart disease patients, but meta-analysis of randomized trials in coronary heart disease patients showed no significant effect of antibiotics on mortality. Here we report the 6-year mortality of clarithromycin- versus placebo-exposed patients and updated meta-analyses. Methods: Centrally randomized, placebo controlled multicenter trial. All parties were blinded. Analyses were by intention to treat. Meta-analyses followed the Cochrane Collaboration methodology. Results: We randomized 4,372 patients with stable coronary heart disease to clarithromycin 500 mg (n = 2,172) or placebo (n = 2,200) once daily for 2 weeks. Mortality was followed through public register. Nine hundred and twenty-three patients (21.1%) died. Six-year mortality was significantly higher in the clarithromycin group (hazard ratio 1.21, 95% confidence interval 1.06–1.38). Adjustment for entry characteristics (sex, age, prior myocardial infarction, center, and smoking) did not change the results (1.18, 1.04–1.35). Addition of our data to that of other randomized trials on antibiotics for patients with coronary heart disease versus placebo/no intervention (17 trials, 25,271 patients, 1,877 deaths) showed a significantly increased relative risk of death from antibiotics of 1.10 (1.01–1.20) without heterogeneity. Conclusions: Our results stress the necessity to consider carefully the strength of the indication before administering antibiotics to patients with coronary heart disease.
- Subjects :
- Adult
Male
Risk
medicine.medical_specialty
Adolescent
Denmark
Coronary Disease
Placebo
Drug Administration Schedule
law.invention
Randomized controlled trial
Double-Blind Method
Meta-Analysis as Topic
law
Multicenter trial
Clarithromycin
Internal medicine
Confidence Intervals
Odds Ratio
Medicine
Humans
Pharmacology (medical)
Myocardial infarction
Original Research
Aged
Aged, 80 and over
Intention-to-treat analysis
business.industry
Hazard ratio
Middle Aged
medicine.disease
Survival Analysis
Surgery
Anti-Bacterial Agents
Relative risk
Female
Cardiology and Cardiovascular Medicine
business
medicine.drug
Follow-Up Studies
Subjects
Details
- ISSN :
- 14219751
- Volume :
- 111
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Cardiology
- Accession number :
- edsair.doi.dedup.....092af9d35e502dfabe584480db518aef