TY - JOUR
T1 - Statin treatment prevents increased cardiovascular and all-cause mortality associated with clarithromycin in patients with stable coronary heart disease
AU - Jensen, Gorm B
AU - Hilden, Jørgen
AU - Als-Nielsen, Bodil
AU - Damgaard, Morten
AU - Hansen, Jørgen Fischer
AU - Hansen, Stig
AU - Helø, Olav H
AU - Hildebrandt, Per
AU - Kastrup, Jens
AU - Kolmos, Hans Jørn
AU - Kjøller, Erik
AU - Lind, Inga
AU - Nielsen, Henrik
AU - Petersen, Lars
AU - Jespersen, Christian M
AU - Gluud, Christian
AU - CLARICOR Trial Group
AU - Jensen, Gorm B
AU - Hilden, Jørgen
AU - Als-Nielsen, Bodil
AU - Damgaard, Morten
AU - Hansen, Jørgen Fischer
AU - Hansen, Stig
AU - Helø, Olav Holger
AU - Hildebrandt, Per
AU - Kastrup, Jens
AU - Kolmos, Hans Jørn
AU - Kjøller, Erik
AU - Lind, Inga
AU - Nielsen, Henrik
AU - Petersen, Lars
AU - Jespersen, Christian
AU - Gluud, Christian
AU - CLARICOR Trial Group
PY - 2010/2/1
Y1 - 2010/2/1
N2 - In the CLARICOR trial, significantly increased cardiovascular (CV) and all-cause mortality in stable patients with coronary heart disease were observed after a short course of clarithromycin. We report on the impact of statin treatment at entry on the CV and all-cause mortality. The multicenter CLARICOR trial randomized patients to oral clarithromycin (500 mg daily; n = 2172) versus matching placebo (daily; n = 2201) for 2 weeks. Patients were followed through public databases. In the 41% patients on statin treatment at entry, no significant effect of clarithromycin was observed on CV (hazard ratio [HR], 0.68, 95% confidence interval [CI], 0.38-1.22; P = 0.20) or all-cause mortality (HR, 1.08; 95% CI, 0.71-1.65; P = 0.72) at 2.6-year follow up. In the patients not on statin treatment at entry, clarithromycin was associated with a significant increase in CV (HR, 1.90; 95% CI, 1.34-2.67; P = 0.0003; statin-clarithromycin interaction P = 0.0029) and all-cause mortality (HR, 1.33; 95% CI, 1.05-1.67; P = 0.016; statin-clarithromycin interaction P = 0.41). Multivariate analysis and 6-year follow up confirmed these results. Concomitant statin treatment in stable patients with coronary heart disease abrogated the observed increased CV mortality associated with 2 weeks of clarithromycin.
AB - In the CLARICOR trial, significantly increased cardiovascular (CV) and all-cause mortality in stable patients with coronary heart disease were observed after a short course of clarithromycin. We report on the impact of statin treatment at entry on the CV and all-cause mortality. The multicenter CLARICOR trial randomized patients to oral clarithromycin (500 mg daily; n = 2172) versus matching placebo (daily; n = 2201) for 2 weeks. Patients were followed through public databases. In the 41% patients on statin treatment at entry, no significant effect of clarithromycin was observed on CV (hazard ratio [HR], 0.68, 95% confidence interval [CI], 0.38-1.22; P = 0.20) or all-cause mortality (HR, 1.08; 95% CI, 0.71-1.65; P = 0.72) at 2.6-year follow up. In the patients not on statin treatment at entry, clarithromycin was associated with a significant increase in CV (HR, 1.90; 95% CI, 1.34-2.67; P = 0.0003; statin-clarithromycin interaction P = 0.0029) and all-cause mortality (HR, 1.33; 95% CI, 1.05-1.67; P = 0.016; statin-clarithromycin interaction P = 0.41). Multivariate analysis and 6-year follow up confirmed these results. Concomitant statin treatment in stable patients with coronary heart disease abrogated the observed increased CV mortality associated with 2 weeks of clarithromycin.
U2 - 10.1097/fjc.0b013e3181c87e37
DO - 10.1097/fjc.0b013e3181c87e37
M3 - Journal article
C2 - 19920766
SN - 0160-2446
VL - 55
SP - 123
EP - 128
JO - Journal of Cardiovascular Pharmacology
JF - Journal of Cardiovascular Pharmacology
IS - 2
ER -