阿齐思罗米用于冠心病事件的二次预防:WIZARD研究:一种随机对照试验
Christopher M O'Connor1, Michael W Dunne, Marc A Pfeffer
1Duke University, Durham NC, USA.
JAMA
|September 18, 2003
概括
抗生素治疗的阿齐思罗米并没有显著减少冠状动脉心脏病的事件,在患者之前心肌梗塞和克拉米迪亚肺炎暴露. 这种为期12周的治疗对重大心脏事件或相关住院治疗没有益处.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 冠状病毒肺炎感染与动脉样硬化的发展有关.
- 了解传染病在冠心病中的作用对于有效的预防和治疗策略至关重要.
研究的目的:
- 评估12周抗生素治疗方案在预防主要心脏不良事件方面的有效性.
- 为了确定阿齐思罗米辛治疗是否会影响记录的克拉米迪亚肺炎暴露和心肌梗塞病史的患者的冠状动脉心脏病后续.
主要方法:
- 一个大规模的,随机的,安慰剂对照试验,涉及7747名先前心肌梗塞的成年人.
- 参与者接受了12周的阿齐思罗米或安慰剂,随访直到发生1038次主要事件.
- 主要终点包括全因死亡,非致命的心脏复发,冠状动脉再血管化或与胸痛相关的住院治疗.
主要成果:
- 与安慰剂相比,阿兹罗密辛治疗没有显著降低初级复合终点事件的发生率 (7%的风险降低,P=.23).
- 虽然早期的趋势表明有好处,但随着时间的推移,这些影响逐渐减弱,死亡,心脏复发,再血管化或胸痛住院的病例没有显著减少.
- 副作用,主要是腹,在阿齐思罗米组中更频繁,导致更高的药物停用率.
结论:
- 3个月的阿齐思罗米辛疗程在稳定患者中没有有效的降低冠心病的临床结果,这些患者先前患有心肌梗塞和克拉米迪亚肺炎感染的证据.
- 这些发现不支持在这个特定的患者群体中使用阿齐思罗米作为心血管事件的二次预防.
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