Clarithromycin May Be Linked to Cardiovascular Events

Clarithromycin May Be Linked to Cardiovascular Events

Findings for hospitalized patients with acute exacerbations of COPD, pneumonia

FRIDAY, March 22 (HealthDay News) -- For patients with acute exacerbations of chronic obstructive pulmonary disease or community-acquired pneumonia, use of clarithromycin correlates with increased risk of cardiovascular events, according to a study published online March 22 in BMJ.

Stuart Schembri, M.D., from Ninewells Hospital in Dundee, U.K., and colleagues analyzed two prospectively collected datasets to examine the correlation between clarithromycin use and cardiovascular events. Data were assessed for 1,343 patients admitted to the hospital with acute exacerbations of chronic obstructive pulmonary disease and 1,631 with community-acquired pneumonia.

Over one year, the researchers identified 268 cardiovascular events in the acute exacerbations of chronic obstructive pulmonary disease cohort and 171 in the pneumonia cohort. Use of clarithromycin for acute exacerbations of chronic obstructive pulmonary disease correlated with an elevated risk of cardiovascular events (hazard ratio [HR], 1.50) and acute coronary syndrome (HR, 1.67), after multivariable adjustment. The correlation with cardiovascular events persisted after propensity matching. Use of clarithromycin in the pneumonia cohort correlated with an increased risk of cardiovascular events (HR, 1.68) but no significant increase in the risk of acute coronary syndrome. In chronic obstructive pulmonary disease, use of clarithromycin correlated with an increased risk of cardiovascular (adjusted HR, 1.52), but not all-cause mortality; there was no correlation with mortality in pneumonia. There were more cardiovascular events with longer duration of clarithromycin use.

"The use of clarithromycin in the setting of hospital admissions for infective exacerbations of chronic obstructive pulmonary disease or community acquired pneumonia may be associated with increased cardiovascular events," the authors write.

Full Text (http://www.bmj.com/content/346/bmj.f1235 )