The effects of short term clarithromycin treatment on endothelial dysfunction, QT dispersion and blood fibrinogen levels in acute coronary syndrome patients

In this study, we aimed to demonstrate the effects of clarithromycin treatment on endothelial dysfunction, blood fibrinogen level and QTd iizer in acute coronary syndromes. Forty cases (21 males, 19 females; mean age 56,39 + 12 years) were included in the study. Twenty patients treated with clarithromycin: antibiotic group (12 male, 8 female; mean age 58.9 + 11.6 years) and 20 patients (9 male, 11 female; mean age 53.15 + 8 years) who did not receive clarithromycin treatment. ) were divided into two groups. Age, sex and smoking and cardiovascular risk factors were similar in both groups. The treatment other than clarithromycin was standardized in both groups. (B-blocker, heparin, nitrate, ACE-inh, statin and aspirin). In the antibiotic group, 1000 mg / grin Clarithromycin peroral (Klacid & 500 mg tablets 2x1) was given in addition to standard treatment for 7 grin irrespective of chlamydia pneumonia and H. pylori serology. No side effects were observed in the patient groups. Statistical analysis was performed by using SPSS program (Version 10.0). Quantitative variables were expressed as mean + standard deviation, and qualitative variables were expressed as%. The difference between quantitative variables was evaluated by Mann-Whitney U test and the difference between qualitative variables was evaluated by chi-square test (classical and Fischer's exact chi-square test). Pearson and Spearman correlation analysis methods were used for correlation analysis. P <0.05 was considered significant. Effect of clarithromycin on endothelial dysfunction: After treatment, the percentage of dilatation, which is indicative of endothelial dysfunction, increased significantly in the antibiotic group compared to the pre-treatment level. A significant increase was observed in the percentage of dilatation in the control group. When this change in antibiotic and control groups were compared with each other, no statistically significant difference was observed. This result revealed that endothelial function improved in both groups in the acute period, but the improvement in endothelial dysfunction was not different between the two groups. Effect of clarithromycin on blood fibrinogen level: After treatment, fibrinogen level, which is one of the predictors of acute inflammation and CAD risk, decreased significantly in the antibiotic group compared to the pre-treatment level. Significant fibrinogen levels in the control group a decrease was observed. When the decrease in fibrinogen levels in the antibiotic and control groups was compared with each other, no statistically significant difference was observed. Effect of clarithromycin on QTd and QTcd: QTd values were increased due to ischemia in both groups. After treatment, QTd and QTcd, which are indicative of arrhythmogenic susceptibility, were significantly increased in the antibiotic group compared to the pretreatment group. There was no significant increase in the control group after the treatment compared to the pre-treatment. When the changes in QTd and QTcd in the antibiotic and control groups were analyzed with each other, a significant difference was observed between the two groups. Our results showed that QTd increased in the antibiotic group receiving clarithromycin compared to the control group. Short-term clarithromycin treatment has not shown additional benefit in correcting endothelial dysfunction and reducing fibrinogen, an inflammatory marker. It has even been observed that QTd is increased, which may be thought to be arrhythmogenic. In the light of our findings, in addition to the classical treatment of acute coronary syndromes, we recommend that such pilot studies with different antibiotics be performed in different poems until the results of mortality-morbidity studies are obtained.