Statin treatment prevents increased cardiovascular and all-cause mortality associated with clarithromycin in patients with stable coronary heart disease

Research output: Contribution to journalJournal articleResearchpeer-review

  • Gorm B Jensen
  • Hilden, Jørgen
  • Bodil Als-Nielsen
  • Morten Damgaard
  • Jørgen Fischer Hansen
  • Stig Hansen
  • Olav H Helø
  • Per Hildebrandt
  • Jens Kastrup
  • Hans Jørn Kolmos
  • Erik Kjøller
  • Inga Lind
  • Henrik Nielsen
  • Lars Petersen
  • Christian M Jespersen
  • Christian Gluud
  • CLARICOR Trial Group
  • Gorm B Jensen
  • Jørgen Hilden
  • Bodil Als-Nielsen
  • Morten Damgaard
  • Jørgen Fischer Hansen
  • Stig Hansen
  • Olav Holger Helø
  • Per Hildebrandt
  • Jens Kastrup
  • Hans Jørn Kolmos
  • Erik Kjøller
  • Inga Lind
  • Henrik Nielsen
  • Lars Petersen
  • Christian Jespersen
  • Christian Gluud
  • CLARICOR Trial Group
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.
Original languageEnglish
JournalJournal of Cardiovascular Pharmacology
Volume55
Issue number2
Pages (from-to)123-8
Number of pages6
ISSN0160-2446
DOIs
Publication statusPublished - 1 Feb 2010

ID: 20544589