This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To The Editor: Dr O'Connor and colleagues¹ reported that a 3-month course of azithromycin did not significantly reduce the clinical sequelae of coronary heart disease (CHD) among stable patients with previous myocardial infarction and evidence of Chlamydia pneumoniae exposure. Exposure to this pathogen is, in fact, highly prevalent in the population (more than 80% of people older than 65 years may have the antibody).²

The authors' results are not entirely surprising. A likely explanation for an association between infection and CHD is through chronic inflammation. Epidemiologic studies^2-4 have documented an independent association between the inflammatory marker C-reactive protein (CRP) and CHD, leading to a consensus document stressing the likely importance of chronic inflammation in CHD. ⁵ Unfortunately, the presence of IgG antibody to C pneumoniae, the criterion for entry into the study of O'Connor et al, does not confirm an ongoing chronic infection. It is likely that some of these . . . [Full Text of this Article]

Geoffrey A. Modest, MD
Department of Medicine
Boston University School of Medicine
Boston, Mass

Julie Kaufmann, MD, PhD
Department of Medicine
Beth Israel Deaconness Medical Center
Boston

RELATED ARTICLES

Antibiotics and Coronary Heart Disease
F. Javier Nieto
JAMA. 2004;291(3):302-303.
EXTRACT | FULL TEXT  

Antibiotics and Coronary Heart Disease—Reply
Michael W. Dunne, Rebecca J. Benner, Christopher M. O'Connor, Marc A. Pfeffer, Joseph B. Muhlestein, Louis Yao, Sandeep Gupta, Marian R. Fisher, and Thomas D. Cook
JAMA. 2004;291(3):303.
EXTRACT | FULL TEXT  

Antibiotics and Coronary Heart Disease—Reply
Sorin Pislaru and Frans Van de Werf
JAMA. 2004;291(3):303.
EXTRACT | FULL TEXT  

Azithromycin for the Secondary Prevention of Coronary Heart Disease Events: The WIZARD Study: A Randomized Controlled Trial
Christopher M. O'Connor, Michael W. Dunne, Marc A. Pfeffer, Joseph B. Muhlestein, Louis Yao, Sandeep Gupta, Rebecca J. Benner, Marian R. Fisher, and Thomas D. Cook
JAMA. 2003;290(11):1459-1466.
ABSTRACT | FULL TEXT