(Circulation. 1999;99:1555-1559.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Treatment of Helicobacter pylori and Chlamydia pneumoniae Infections Decreases Fibrinogen Plasma Level in Patients With Ischemic Heart Disease
From the Emergency Department (G.T., R.C., C.M., G.V., T. V. T., G.C.), Institute of Respiratory Disease (F.B., P.T., C.A.), Institute of Hygiene (M.L.R.), and Hemodynamic Unit (R.P.), Ospedale Maggiore, IRCCS, Milan, Italy.
Correspondence to Giuseppe Torgano, MD, Divisione di Medicina d'Urgenza, Ospedale Maggiore-IRCCS, Via F Sforza 35, 20122 Milano, Italy. E-mail medurg1{at}polic.cilea.it
Background—Chronic Chlamydia pneumoniae and Helicobacter pylori infections could be a risk factor for ischemic heart disease (IHD), possibly by increasing fibrinogen levels. The aim of our study was to evaluate changes in fibrinogen level in patients with IHD and H pylori and/or C pneumoniae positivity randomly assigned to antibiotic treatment.
Methods and Results—Eighty-four patients with chronic IHD, H pylori and/or C pneumoniae antibodies, and normal acute-phase reactants were randomly assigned to treatment or no treatment. Treatment consisted of omeprazole, clarithromycin, and tinidazole in H pylori–positive patients and clarithromycin alone in C pneumoniae–positive patients. The effect of treatment and other baseline variables on fibrinogen levels, determined at 6 months, was evaluated by multivariate analysis. Treatment significantly reduced fibrinogen level at 6 months in the overall study population and in the groups of patients divided according to H pylori or C pneumoniae positivity. In the 43 treated patients, mean (±SD) basal fibrinogen was 3.65±0.58 g/L, and mean final fibrinogen was 3.09±0.52 g/dL (P<0.001), whereas in the 41 untreated patients, mean basal and final fibrinogen levels were 3.45±0.70 and 3.61±0.71 g/L, respectively. The largest decrease was observed in patients with both infections. Fibrinogen changes were also significantly and negatively correlated with age.
Conclusions—Our data suggest that a short, safe, and effective course of antibiotic therapy might be suggested as a means of interacting with an "emerging" risk factor.
Key Words: ischemia • fibrinogen • H pylori • C pneumoniae
This article has been cited by other articles:
 |
|
 |
|
  R. Andraws, J. S. Berger, and D. L. Brown Effects of Antibiotic Therapy on Outcomes of Patients With Coronary Artery Disease: A Meta-analysis of Randomized Controlled Trials JAMA, June 1, 2005; 293(21): 2641 - 2647. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G Arno, J C Kaski, D A Smith, J P Akiyu, S E Hughes, and C Baboonian Matrix metalloproteinase-9 expression is associated with the presence of Chlamydia pneumoniae in human coronary atherosclerotic plaques Heart, April 1, 2005; 91(4): 521 - 525. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Wells, A. G. Mainous III, and L. M. Dickerson Antibiotics for the Secondary Prevention of Ischemic Heart Disease: A Meta-analysis of Randomized Controlled Trials Arch Intern Med, October 25, 2004; 164(19): 2156 - 2161. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Diomedi, A. Pietroiusti, M. Silvestrini, B. Rizzato, L. M. Cupini, F. Ferrante, A. Magrini, A. Bergamaschi, A. Galante, and G. Bernardi CagA-positive Helicobacter pylori strains may influence the natural history of atherosclerotic stroke Neurology, September 14, 2004; 63(5): 800 - 804. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P. Higgins Chlamydia pneumoniae and Coronary Artery Disease: The Antibiotic Trials Mayo Clin. Proc., March 1, 2003; 78(3): 321 - 332. [Abstract] [PDF]
|
|
|
|
 |
|
 A. F.M. Stone, M. A. Mendall, J.-C. Kaski, T. M. Edger, P. Risley, J. Poloniecki, A. J. Camm, and T. C. Northfield Effect of Treatment for Chlamydia pneumoniae and Helicobacter pylori on Markers of Inflammation and Cardiac Events in Patients With Acute Coronary Syndromes: South Thames Trial of Antibiotics in Myocardial Infarction and Unstable Angina (STAMINA) Circulation, September 3, 2002; 106(10): 1219 - 1223. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Franceschi, A. R. Sepulveda, A. Gasbarrini, P. Pola, N. G. Silveri, G. Gasbarrini, D. Y. Graham, and R. M. Genta Cross-Reactivity of Anti-CagA Antibodies With Vascular Wall Antigens: Possible Pathogenic Link Between Helicobacter pylori Infection and Atherosclerosis Circulation, July 23, 2002; 106(4): 430 - 434. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Wiesli, W. Czerwenka, A. Meniconi, F. E. Maly, U. Hoffmann, W. Vetter, and G. Schulthess Roxithromycin Treatment Prevents Progression of Peripheral Arterial Occlusive Disease in Chlamydia pneumoniae Seropositive Men: A Randomized, Double-Blind, Placebo-Controlled Trial Circulation, June 4, 2002; 105(22): 2646 - 2652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Vainas, H. A.J.M. Kurvers, W. H. Mess, R. d. Graaf, R. Ezzahiri, J. H.M. Tordoir, G.-W. H. Schurink, C. A. Bruggeman, and P. J.E.H.M. Kitslaar Chlamydia pneumoniae Serology Is Associated With Thrombosis-Related but Not With Plaque-Related Microembolization During Carotid Endarterectomy Stroke, May 1, 2002; 33(5): 1249 - 1254. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Tavendale, D. Parratt, S.D. Pringle, R. A'brook, and H. Tunstall-Pedoe Serological markers of Chlamydia pneumoniae infection in men and women and subsequent coronary events. The Scottish Heart Health Study Cohort Eur. Heart J., February 2, 2002; 23(4): 301 - 307. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Boman and M. R. Hammerschlag Chlamydia pneumoniae and Atherosclerosis: Critical Assessment of Diagnostic Methods and Relevance to Treatment Studies Clin. Microbiol. Rev., January 1, 2002; 15(1): 1 - 20. [Abstract] [Full Text]
|
|
|
|
|
|
S. C. Johnston, L. M. Messina, W. S. Browner, M. T. Lawton, C. Morris, and D. Dean C-Reactive Protein Levels and Viable Chlamydia pneumoniae in Carotid Artery Atherosclerosis Stroke, December 1, 2001; 32(12): 2748 - 2752. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. W. Fong Emerging relations between infectious diseases and coronary artery disease and atherosclerosis Can. Med. Assoc. J., July 1, 2000; 163(1): 49 - 56. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A.J. Camm and K.M. Fox Chlamydia pneumonia (and other infective agents) in atherosclerosis and acute coronary syndromes. How good is the evidence? Eur. Heart J., July 1, 2000; 21(13): 1046 - 1051. [PDF]
|
|
|
|
 |
|
 T. Quaschning and C. Wanner The role of Chlamydia in coronary heart disease--fact or fiction? Nephrol. Dial. Transplant., December 1, 1999; 14(12): 2800 - 2803. [Full Text] [PDF]
|
|
|
|
|
|
A. Shor and J. I. Phillips Chlamydia pneumoniae and Atherosclerosis JAMA, December 1, 1999; 282(21): 2071 - 2073. [Full Text] [PDF]
|
|