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.
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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. / Gluud, Christian; Als-Nielsen, Bodil; Damgaard, Morten; Fischer Hansen, Jørgen; Hansen, Stig; Helø, Olav H; Hildebrandt, Per; Hilden, Jørgen; Jensen, Gorm Boje; Kastrup, Jens; Kolmos, Hans Jørn; Kjøller, Erik; Lind, Inga; Nielsen, Henrik; Petersen, Lars; Jespersen, Christian M; CLARICOR Trial Group; Gluud, Christian; Als-Nielsen, Bodil; Damgaard, Morten; Fischer Hansen, Jørgen; Hansen, Stig Henrik Strange; Helø, Olav H; Hildebrandt, Per; Hilden, Jørgen; Jensen, Gorm Boje; Kastrup, Jens; Kolmos, Hans Jørn; Kjøller, Erik; Lind, Inga; Nielsen, Henrik; Petersen, Lars; Jespersen, Christian M.
I: Cardiology, Bind 111, Nr. 4, 2008, s. 280-287.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - 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.
AU - Gluud, Christian
AU - Als-Nielsen, Bodil
AU - Damgaard, Morten
AU - Fischer Hansen, Jørgen
AU - Hansen, Stig
AU - Helø, Olav H
AU - Hildebrandt, Per
AU - Hilden, Jørgen
AU - Jensen, Gorm Boje
AU - Kastrup, Jens
AU - Kolmos, Hans Jørn
AU - Kjøller, Erik
AU - Lind, Inga
AU - Nielsen, Henrik
AU - Petersen, Lars
AU - Jespersen, Christian M
AU - CLARICOR Trial Group
AU - Gluud, Christian
AU - Als-Nielsen, Bodil
AU - Damgaard, Morten
AU - Fischer Hansen, Jørgen
AU - Hansen, Stig Henrik Strange
AU - Helø, Olav H
AU - Hildebrandt, Per
AU - Hilden, Jørgen
AU - Jensen, Gorm Boje
AU - Kastrup, Jens
AU - Kolmos, Hans Jørn
AU - Kjøller, Erik
AU - Lind, Inga
AU - Nielsen, Henrik
AU - Petersen, Lars
AU - Jespersen, Christian M
N1 - Keywords: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Clarithromycin; Confidence Intervals; Coronary Disease; Denmark; Double-Blind Method; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Male; Meta-Analysis as Topic; Middle Aged; Odds Ratio; Risk; Survival Analysis
PY - 2008
Y1 - 2008
N2 - 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.
AB - 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.
U2 - 10.1159/000128994
DO - 10.1159/000128994
M3 - Journal article
C2 - 18451646
VL - 111
SP - 280
EP - 287
JO - Cardiologia
JF - Cardiologia
SN - 0008-6312
IS - 4
ER -
ID: 14309179