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Heart Disease (Expert Forum)
Re: Chlamydia pneumoniae/H. pylori/cytomegalovirus
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.
Re: Chlamydia pneumoniae/H. pylori/cytomegalovirus
by Gordon-Mage, Jan 01, 1995 12:00AM
Posted By Gordon Magee on October 01, 1998 at 10:39:30:
In Reply to: Re: Chlamydia pneumoniae/H. pylori/cytomegalovirus posted by CCF CARDIO MD - DLB on September 30, 1998 at 19:05:32:
: : : : After reading some information from a couple of e-mail services, and doing
: : : : research in medical research engines I am wondering about the helpfulness
: : : : taking an antibiotic treatment to rid the body, particularly of the
: : : : chlamydia p. to do away with the "smoldering inflammation" as it has been
: : : : called.
: : Any opinions on whether this may be effective?
: : I am 47 and had my first MI at 39, another at 43, and have had 4 angioplasties,
: : : : the last on in Feb, which included 3 stents.
: : Doing fine, playing basketball etc, but am hopefull of stopping the progression
: : : : of the atherosclerosis.
: ---------------------------------------------------------------------------------------------------------------------------------
: Dear Gordon
: At this point in time, I would not recommend taking antibiotics. They are expensive, have potential side effects, and their indiscriminate use breeds resistant organisms that go on to cause serious disease. There is no convincing evidence that infection plays a role in human coronary artery disease. Inflammation definitely occurs within atherosclerotic plaque, but the link to infection has not been made as of yet. In addition, the epidemiological studies are conflicting regarding the role of infectious agents in heart disease.
: I wish you the best of luck. Feel free to write back.
: If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15. Information provided in the Heart Forum is for general purposes only. Specific diagnoses and therapies can only be provided by your doctor.
Dear Doctor: Thanks for the quick response. Given the relatively rapid progression
: : of my disease, I am wanting to do whatever I can to arrest it, as I am sure you
: : can imagine. I am in agreement about the use of antibiotics and the care that
: : must be taken.
In reading some of the abstracts at the Medline web site after doing a search on
: : chlamydia, it would appear that the evidence is mounting strongly in favor of
: : their being linkage between chlamydia pn. and atherosclerosis . In addition,
: : several professional medical journals in the past year have published information
: : of studies that, while not being fully conclusive, point strongly toward a link.
In that the progression of my disease is such that I have about a 5 year window
: : before I am likely to have need for another procedure, and in that I would like
: : to avoid by-pass surgery, I have begun the antiobiotic treatment now, rather than
: : wait for the test results. I know that even if a link is definitively identified
: : , it will NOT be the single cause for heart disease and that taking antiobiotics
: : is not something every one should do.
However, who would have imagined just a few years ago, the amazing results with
: : ulcers being treated with antibiotics.
Perhaps VEG-F injections will be the norm for some one like me in 5 or 6 years.
: : I would be interested in any comments you may have about VEG-F injections and
: : their viability as a major heart disease treatment in the coming years.
Thank you for your thoughtfulness in responding. I can't tell you how helpful
: : it is to be able to access through the internet, top notch information from
: : which to make informed decisions.
You are appreciated, as is this over all information service.
-------------------------------------------------------------------------------------------------------------
: Dear Gordon
I fully understand your desire to try and halt the progression of coronary disease. I am aware of the literature on infection (in particular, Chlamydia pneumoniae) and coronary disease. In fact, I am working on a basic science project that is looking at the role of Chlamydia in causing coronary artery plaque formation and possible heart attacks. Nonetheless, I would not recommend long-term treatment with any medicine, including antibiotics, until it is proven to be safe and effective. The history of medicine is full of examples of drugs that looked like miracle cures, only to turn out to be useless (or dangerous). I am curious, what antibiotic do you plan to take, at what dose, and for how long?
We at the Cleveland Clinic are involved with clinical trials of VEGF in patients who are not candidates for angioplasty or bypass surgery. I do think that some version of "gene therapy" will play a role in treating advanced coronary artery disease. I think meaningful clinical applications are still several years away. I am also concerned about targeting the therapy so that new blood vessels form in the heart, as opposed to the eye or a budding cancer. However, I am optimistic about a number of new therapies in the next few years, for people just like you.
I am assuming that you have had things like your LDL and HDL cholesterol measured (and treated). How about the more esoteric tests, such as a homocysteine level?
I hope this is useful. Feel free to write back. I wish you the best of luck.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).
Dear Doctor,
The antiobiotics that I am taking are a 7 day course. Like you, I would not want
do a long term course. Unfortunately I do not have the prescriptions here at the
office. One is Prilosec (likely misspelled!) and another is in the "mycin" family
as in Azithromycin, but that is not the drug. A third drug I am taking is to
help with any stomach upset. I vaguely remember reading on the label something
about it being a "proton pump inhibitor". That may not be the correct phrase,
but I am sure you know what I mean. (dose? I would have to check)
Low HDL is one of my problems. Prior to being on medication is was below 35.
Mevacor would bring it up to 42, but over time I continued to have problems,
so I went on Zocor, and then when Lipitor came out, I changed over. My last
readings in May of 98, when we boosted the lipitor to 40 mg, were: total chol.
133, HDL 33, LDL 73, Triglyc. 165. So over all, not bad, but the HDL could
be better.
In May of 1993 when I had an emergency angioplasty from an MI in the LOBBY of
the Mayo Clinic, they checked my homocysteine. It was normal, but I don't know
what the number was. Dr. Peter Berger, who had done the emergency procedure,
was also just ready to publish some info. on homocysteine. Because of his awareness
of the link at that early time, he checked me out. I don't know if "normal" has
taken on a new meaning in the interim or not.
The VEGF concept looks promising to me. I have blockages in my LAD, R. coronary
and R.(?) circumflex. I narrowly avoided by-pass surgery this time. The skill
of the guys as Mayo and my strong desire to avoid it as long as possible gave
me another shot. The angiopl. door still isn't closed, depending on where new
lesions might develop, but I would like to see some reversal take place. With
the chol. levels I have now, I think that is possible, but some of the plaques
are likely so tight that reversal is not likely unless some other mechanism
kicks in ala the antibiotic treatment or the like.
The fact that you are doing research on the chlamydia ph. yourself, also gives
me some optimism. If there were no possibilities, then that research door might
likely already be closed. I am realistic about my possibilties and not unaware
that I may get little or no help from the antiobiotics, but felt that it would be
worth a shot.
Thanks again for your help. I will await your comments on the above.
-------------------------------------------------------------------------------------------------------------
Dear Gordon
Everything you have written is quite logical, although I still would not recommend antibiotic treatment at this time. I suspect you are taking clarithromycin, which is generally very well tolerated (especially for seven days).
The cholesterol profile looks pretty good. If the homocysteine level was normal then, I would not worry about it now. I imagine that you eat a healthy diet including green, leafy vegetables and foods rich in folate (the proposed treatment for an elevated homocysteine) anyway.
Your doctors at Mayo would also be aware of the latest advances in coronary artery disease.
I hope this is useful. Feel free to write back. I wish you the best of luck.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).
Dear Doctor,
This is a final follow-up, no need to respond. You had asked yesterday about
what antibiotics I was taking. You were correct, clarithromycin(250mg) (brand name
Biaxin) is one, Metronidazol (250mg) is another. Omeprazole(20mg) (brand name Prilosec)
, which I mistakenly remembered yesterday as an antiobiotic, is also one that
I am taking along with the antibiotics. It is the proton pump inhibitor, which
I suspect is just to help with any stomach problems during the regimen of antibiotics.
Thanks Doc. Your information was very helpful!
Gordon
In Reply to: Re: Chlamydia pneumoniae/H. pylori/cytomegalovirus posted by CCF CARDIO MD - DLB on September 30, 1998 at 19:05:32:
: : : : After reading some information from a couple of e-mail services, and doing
: : : : research in medical research engines I am wondering about the helpfulness
: : : : taking an antibiotic treatment to rid the body, particularly of the
: : : : chlamydia p. to do away with the "smoldering inflammation" as it has been
: : : : called.
: : Any opinions on whether this may be effective?
: : I am 47 and had my first MI at 39, another at 43, and have had 4 angioplasties,
: : : : the last on in Feb, which included 3 stents.
: : Doing fine, playing basketball etc, but am hopefull of stopping the progression
: : : : of the atherosclerosis.
: ---------------------------------------------------------------------------------------------------------------------------------
: Dear Gordon
: At this point in time, I would not recommend taking antibiotics. They are expensive, have potential side effects, and their indiscriminate use breeds resistant organisms that go on to cause serious disease. There is no convincing evidence that infection plays a role in human coronary artery disease. Inflammation definitely occurs within atherosclerotic plaque, but the link to infection has not been made as of yet. In addition, the epidemiological studies are conflicting regarding the role of infectious agents in heart disease.
: I wish you the best of luck. Feel free to write back.
: If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at Desk F15. Information provided in the Heart Forum is for general purposes only. Specific diagnoses and therapies can only be provided by your doctor.
Dear Doctor: Thanks for the quick response. Given the relatively rapid progression
: : of my disease, I am wanting to do whatever I can to arrest it, as I am sure you
: : can imagine. I am in agreement about the use of antibiotics and the care that
: : must be taken.
In reading some of the abstracts at the Medline web site after doing a search on
: : chlamydia, it would appear that the evidence is mounting strongly in favor of
: : their being linkage between chlamydia pn. and atherosclerosis . In addition,
: : several professional medical journals in the past year have published information
: : of studies that, while not being fully conclusive, point strongly toward a link.
In that the progression of my disease is such that I have about a 5 year window
: : before I am likely to have need for another procedure, and in that I would like
: : to avoid by-pass surgery, I have begun the antiobiotic treatment now, rather than
: : wait for the test results. I know that even if a link is definitively identified
: : , it will NOT be the single cause for heart disease and that taking antiobiotics
: : is not something every one should do.
However, who would have imagined just a few years ago, the amazing results with
: : ulcers being treated with antibiotics.
Perhaps VEG-F injections will be the norm for some one like me in 5 or 6 years.
: : I would be interested in any comments you may have about VEG-F injections and
: : their viability as a major heart disease treatment in the coming years.
Thank you for your thoughtfulness in responding. I can't tell you how helpful
: : it is to be able to access through the internet, top notch information from
: : which to make informed decisions.
You are appreciated, as is this over all information service.
-------------------------------------------------------------------------------------------------------------
: Dear Gordon
I fully understand your desire to try and halt the progression of coronary disease. I am aware of the literature on infection (in particular, Chlamydia pneumoniae) and coronary disease. In fact, I am working on a basic science project that is looking at the role of Chlamydia in causing coronary artery plaque formation and possible heart attacks. Nonetheless, I would not recommend long-term treatment with any medicine, including antibiotics, until it is proven to be safe and effective. The history of medicine is full of examples of drugs that looked like miracle cures, only to turn out to be useless (or dangerous). I am curious, what antibiotic do you plan to take, at what dose, and for how long?
We at the Cleveland Clinic are involved with clinical trials of VEGF in patients who are not candidates for angioplasty or bypass surgery. I do think that some version of "gene therapy" will play a role in treating advanced coronary artery disease. I think meaningful clinical applications are still several years away. I am also concerned about targeting the therapy so that new blood vessels form in the heart, as opposed to the eye or a budding cancer. However, I am optimistic about a number of new therapies in the next few years, for people just like you.
I am assuming that you have had things like your LDL and HDL cholesterol measured (and treated). How about the more esoteric tests, such as a homocysteine level?
I hope this is useful. Feel free to write back. I wish you the best of luck.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).
Dear Doctor,
The antiobiotics that I am taking are a 7 day course. Like you, I would not want
do a long term course. Unfortunately I do not have the prescriptions here at the
office. One is Prilosec (likely misspelled!) and another is in the "mycin" family
as in Azithromycin, but that is not the drug. A third drug I am taking is to
help with any stomach upset. I vaguely remember reading on the label something
about it being a "proton pump inhibitor". That may not be the correct phrase,
but I am sure you know what I mean. (dose? I would have to check)
Low HDL is one of my problems. Prior to being on medication is was below 35.
Mevacor would bring it up to 42, but over time I continued to have problems,
so I went on Zocor, and then when Lipitor came out, I changed over. My last
readings in May of 98, when we boosted the lipitor to 40 mg, were: total chol.
133, HDL 33, LDL 73, Triglyc. 165. So over all, not bad, but the HDL could
be better.
In May of 1993 when I had an emergency angioplasty from an MI in the LOBBY of
the Mayo Clinic, they checked my homocysteine. It was normal, but I don't know
what the number was. Dr. Peter Berger, who had done the emergency procedure,
was also just ready to publish some info. on homocysteine. Because of his awareness
of the link at that early time, he checked me out. I don't know if "normal" has
taken on a new meaning in the interim or not.
The VEGF concept looks promising to me. I have blockages in my LAD, R. coronary
and R.(?) circumflex. I narrowly avoided by-pass surgery this time. The skill
of the guys as Mayo and my strong desire to avoid it as long as possible gave
me another shot. The angiopl. door still isn't closed, depending on where new
lesions might develop, but I would like to see some reversal take place. With
the chol. levels I have now, I think that is possible, but some of the plaques
are likely so tight that reversal is not likely unless some other mechanism
kicks in ala the antibiotic treatment or the like.
The fact that you are doing research on the chlamydia ph. yourself, also gives
me some optimism. If there were no possibilities, then that research door might
likely already be closed. I am realistic about my possibilties and not unaware
that I may get little or no help from the antiobiotics, but felt that it would be
worth a shot.
Thanks again for your help. I will await your comments on the above.
-------------------------------------------------------------------------------------------------------------
Dear Gordon
Everything you have written is quite logical, although I still would not recommend antibiotic treatment at this time. I suspect you are taking clarithromycin, which is generally very well tolerated (especially for seven days).
The cholesterol profile looks pretty good. If the homocysteine level was normal then, I would not worry about it now. I imagine that you eat a healthy diet including green, leafy vegetables and foods rich in folate (the proposed treatment for an elevated homocysteine) anyway.
Your doctors at Mayo would also be aware of the latest advances in coronary artery disease.
I hope this is useful. Feel free to write back. I wish you the best of luck.
If you would like to set up an appointment with one of our cardiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE.
Information provided in the Heart Forum is intended for general medical informational purposes only. Actual diagnosis and treatment of any particular medical condition can only be made by your physician(s).
Dear Doctor,
This is a final follow-up, no need to respond. You had asked yesterday about
what antibiotics I was taking. You were correct, clarithromycin(250mg) (brand name
Biaxin) is one, Metronidazol (250mg) is another. Omeprazole(20mg) (brand name Prilosec)
, which I mistakenly remembered yesterday as an antiobiotic, is also one that
I am taking along with the antibiotics. It is the proton pump inhibitor, which
I suspect is just to help with any stomach problems during the regimen of antibiotics.
Thanks Doc. Your information was very helpful!
Gordon
