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Inflammation, Infection and Atherosclerosis

Do Antibacterials Have a Role in the Therapy of Coronary Artery Disease?

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Abstract

Since the recent publication of 3 studies on the use of antibacterials in patients with coronary artery disease (CAD), there has been a phenomenal interest in the role of infection in the genesis of CAD. It is now generally accepted that inflammation accompanies atherosclerosis from its initiation to the evolution of end-events. Inflammation may occur in response to traditional risk factors, such as hyperlipidaemia, smoking and diabetes mellitus. There is a recent resurgence of the concept that inflammation may have an infectious basis. This concept is based on the identification of microorganisms in the atherosclerotic plaque and seropositivity. The data on eradication of the offending organism with antibiotics and prevention of atherosclerosis-related events have, however, been inconsistent. This may reflect lack of precise understanding of steps leading to atherosclerosis and the evolution of acute ischaemic events. Further work in this area may help identify subsets of patient populations within which infection may play a causative role in the genesis of CAD. Targeted therapy then may be considered logical.

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  1. Department of Medicine, Division of Cardiology, University of Florida College of Medicine and VA Medical Center, Gainesville, Florida, USA

    Jawahar L. Mehta

  2. Department of Cardiology, Second University of Rome, Rome, Italy

    Francesco Romeo

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Mehta, J.L., Romeo, F. Inflammation, Infection and Atherosclerosis. Drugs 59, 159–170 (2000). https://doi.org/10.2165/00003495-200059020-00001

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