Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Heart Disease (Expert Forum)
CAD - Infectious disease relationship
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
CAD - Infectious disease relationship
by d56auction, Aug 21, 2002 12:00AM
51 yo male. No risk factors...no family history, low BP, excellent lipids, regular exerciser, never smoked, moderate alcohol. After routine physical had a Heart Score of 600 followed up with normal stress ECHO. Within twelve months experienced very slight angina on exercise leading to balloon angioplasty (without stent) for 95% blockage of left ant descending. Now taking Plavix, Pravachol, and Altace in addition to B vitamins and calcium.
Although my CRP was low I did have a Chlamydia pneumoniae titer of 1:256 and I have been treated for Helicobacter pylori for GERD.
1. Any current thoughts or references on their relationship to CAD? Some recent publications associated H. pylori with stroke.
2. Is it thought that the process of stenosis due to infectious agents ongoing or limited to the periods where antibody titers may be high?
3. Any idea on how fast stenosis occurs...i.e. I had a "normal" stress ECHO and within 12 months had a substantial blockage.
Thanks.
Although my CRP was low I did have a Chlamydia pneumoniae titer of 1:256 and I have been treated for Helicobacter pylori for GERD.
1. Any current thoughts or references on their relationship to CAD? Some recent publications associated H. pylori with stroke.
2. Is it thought that the process of stenosis due to infectious agents ongoing or limited to the periods where antibody titers may be high?
3. Any idea on how fast stenosis occurs...i.e. I had a "normal" stress ECHO and within 12 months had a substantial blockage.
Thanks.
Doctor's Answer
by CCF-M.D.-RCJ, Aug 21, 2002 12:00AM
d56auction,
Your questions are timely. I'll answer them in order.
(1,2): Late-breaking trials from the 51st ACC session were just published in July 3, 2002 JACC issue. The WIZARD trial randomized 7,747 patients wih a history of heart attack to 12 weeks of azithromycin (an antibiotic) or to placebo. The group was followed for 4 years. There was no difference between the two groups in the number of deaths, heart attacks, revascularization procedures or hospitalizations for chest pain. There was no differnece in the outcomes in patients with or without antibody titers. This study had similiar results to the smaller ACADEMIC study published in 2000 (Circulation). A study called the Azithromycin and Coronary Events Study is looking at the effect of 1 years worth of azithromycin, but the results are not in yet.
(3): I heard of a case this year where a patient had a "negative" stress echo and died on the way home of a heart attack. It's a dangerous world.
Your current medical regimen sounds pretty good.
Hope that helps.
Your questions are timely. I'll answer them in order.
(1,2): Late-breaking trials from the 51st ACC session were just published in July 3, 2002 JACC issue. The WIZARD trial randomized 7,747 patients wih a history of heart attack to 12 weeks of azithromycin (an antibiotic) or to placebo. The group was followed for 4 years. There was no difference between the two groups in the number of deaths, heart attacks, revascularization procedures or hospitalizations for chest pain. There was no differnece in the outcomes in patients with or without antibody titers. This study had similiar results to the smaller ACADEMIC study published in 2000 (Circulation). A study called the Azithromycin and Coronary Events Study is looking at the effect of 1 years worth of azithromycin, but the results are not in yet.
(3): I heard of a case this year where a patient had a "negative" stress echo and died on the way home of a heart attack. It's a dangerous world.
Your current medical regimen sounds pretty good.
Hope that helps.
