Antibiotics in the prevention and treatment of coronary heart disease

Seroepidemiology, pathology, and animal studies provide evidence for a poss ible association between Chlamydia pneumoniae infections and atherosclerosi s, coronary heart disease, and myocardial infarction. If this association e xists, then exposure to certain antibiotics may positively affect the clini cal course after an acute ischemic cardiac event (secondary prevention) and affect the risk of developing a first-time myocardial infarction (primary prevention). Preliminary evidence from clinical trials suggests that treatm ent with new macrolide antibiotics may improve outcome after ischemic event s, and evidence from a large case-control analysis indicates that exposure to tetracyclines or quinolones may reduce the risk of developing a first-ti me myocardial infarction. However, antibiotics for the treatment or prevent ion of ischemic heart disease must not be recommended yet. This review of p ublished studies briefly summarizes the currently available literature on t he effects of antibiotics on the risk of developing coronary heart disease and myocardial infarction.