抗生素并不能够减少心脏病发作的风险

一项最新研究显示：稳定型冠状动脉疾病患者使用一年的抗生素并不能够减少心脏病发作或者其它心脏事件的风险。

因为以前的研究发现在冠状动脉疾病患者动脉斑块中有肺炎衣原体存在，研究人员希望了解抗生素是否能够用于治疗细菌，从而减少心脏事件发生的风险。大约有50％的美国成年人在他们的有生之年曾经暴露于C型肺炎。

研究人员随机分配4012例男性和女性接受每周一次的阿奇霉素或者安慰剂共计一年。在平均随访3.9年之后，心脏事件发生并没有显著减少，接受抗生素治疗与接受安慰剂治疗的患者，心脏病发作、不稳定型心绞痛、血管成型术、或者心脏手术并没有显著减少。治疗显示对总体死亡率或者脑卒中发生率并没有影响。试验研究中的男性和女性患有稳定性冠状动脉疾病，既往有心脏事件诸如心脏病发作、血管成型术或者旁路手术。

该项研究的首席研究员、华盛顿大学流行病学教授J. Thomas Grayston医生解释说：“尽管临床冠状心脏病患者使用抗生素治疗并无益处，ACES[ 阿奇霉素和冠状动脉事件研究]试验并没有设计研究C型肺炎诱发或者促进冠状心脏病的影响。”

这项研究得到了美国国立心脏、肺脏与血液研究员的资助，研究结果报道在2005年4月21日的《新英格兰医学期刊》上。
 
Risk of Heart Attack Not Reduced by Antibiotics
 
A new study has shown that taking antibiotics for a year does not reduce the risk of a heart attack or other cardiac event in patients with stable coronary artery disease.

Since previous studies found the bacteria Chlamydia pneumoniae in the arterial plaque of patients with coronary artery disease, researchers wondered whether antiobiotcs could be used to treat the bacteria and thereby reduce the risk of cardiac events. About 50% of U.S. adults have been exposed to C pneumoniae sometime in their lives.

The researchers randomly assigned 4,012 men and women to receive either once-weekly doses of azithromycin or placebo for one year. After an average follow-up of 3.9 years, there was no significant reduction of cardiac events, defined as heart attack, unstable angina, angioplasty, or cardiac surgery among participants who received the antibiotic compared to those given placebo. The treatment also showed no affect on total mortality or on the incidence of stroke. The men and women in the study had stable coronary artery disease following a previous cardiac event such as a heart attack, angioplasty, or bypass surgery.

“Although antibiotic treatment of patients with clinical coronary heart disease is not helpful, the ACES [Azithromycin and Coronary Events Study] study was not designed to find the role of C pneumoniae in the cause or progression of coronary heart disease,” explained J. Thomas Grayston, M.D., professor of epidemiology, University of Washington (Seattle, USA), and the study’s principal investigator.

The study was funded by the U.S. National Heart, Lung, and Blood Institute (Bethesda, MD, USA), and the results were reported in April 21, 2005, issue of The New England Journal of Medicine.