La idea de prevenir episodios cardíacos con antibióticos parte de la posible implicación de la bacteria Chlamydia pneumoniae en este proceso. Varios estudios han hallado que dicha bacteria se encuentra en la placa de ateroma en pacientes que presentan cardiopatía isquémica y se ha planteado la posibilidad que eliminarla con antibióticos podría prevenir eventos coronarios.
Sin embargo, esto no se había comprobado con ensayos clínicos aleatorizados.
El nuevo estudio, llamado ACES, se realizó en 27 centros de Estados Unidos, y el antibiótico utilizado fue la azitromicina. Participaron 4.012 varones y mujeres que recibieron dosis semanales del fármaco o placebo durante un año a partir de 1999. Tras un seguimiento medio de 3,9 años, se observó que el tratamiento antibiótico no aporta ningún beneficio significativo en la prevención de episodios cardíacos (muerte, infarto de miocardio, angina inestable, angioplastia o cirugía cardíaca).
La ausencia de efecto del fármaco fue la misma para todos los participantes, independientemente de su edad, género, consumo de tabaco o presencia de anticuerpos para C. pneumoniae.
Todos los pacientes incluidos presentaban cardiopatía isquémica estable tras haber experimentado un episodio cardíaco previo, como infarto, angioplastia o bypass coronario. El antibiótico utilizado se seleccionó por haber demostrado su efectividad contra C. pneumoniae a la dosis semanal.
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University of Washington
New England Journal of Medicine
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