一項最新研究顯示：穩定型冠狀動脈疾病患者使用一年的抗生素并不能夠減少心臟病發作或者其它心臟事件的風險。

因為以前的研究發現在冠狀動脈疾病患者動脈斑塊中有肺炎衣原體存在，研究人員希望了解抗生素是否能夠用于治療細菌，從而減少心臟事件發生的風險。大約有50％的美國成年人在他們的有生之年曾經暴露于C型肺炎。

研究人員隨機分配4012例男性和女性接受每周一次的阿奇霉素或者安慰劑共計一年。在平均隨訪3.9年之后，心臟事件發生并沒有顯著減少，接受抗生素治療與接受安慰劑治療的患者，心臟病發作、不穩定型心絞痛、血管成型術、或者心臟手術并沒有顯著減少。治療顯示對總體死亡率或者腦卒中發生率并沒有影響。試驗研究中的男性和女性患有穩定性冠狀動脈疾病，既往有心臟事件諸如心臟病發作、血管成型術或者旁路手術。

該項研究的首席研究員、華盛頓大學流行病學教授J. Thomas Grayston醫生解釋說：“盡管臨床冠狀心臟病患者使用抗生素治療并無益處，ACES[ 阿奇霉素和冠狀動脈事件研究]試驗并沒有設計研究C型肺炎誘發或者促進冠狀心臟病的影響。”

這項研究得到了美國國立心臟、肺臟與血液研究員的資助，研究結果報道在2005年4月21日的《新英格蘭醫學期刊》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.