Treatment of Helicobacter pylori and Chlamydia pneumoniae infections decreases fibrinogen plasma level in patients with ischemic heart disease

Background-Chronic Chlamydia pneumoniae and Helicobacter pylori infections could be a risk factor for ischemic heart disease (IHD), possibly by increa sing fibrinogen levels. The aim of our study was to evaluate changes in fib rinogen level in patients with IHD and H pylori and/or C pneumoniae positiv ity 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 ass igned to treatment or no treatment. Treatment consisted of omeprazole, clar ithromycin, 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 evalu ated by multivariate analysis. Treatment significantly reduced fibrinogen l evel at 6 months in the overall study population and in the groups of patie nts divided according to H pylori or C pneumoniae positivity. In the 43 tre ated 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 untreat ed 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 negati vely correlated with age. Conclusions-Our data suggest that a short, safe, and effective course of an tibiotic therapy might be suggested as a means of interacting with an "emer ging" risk factor.