PRELIMINARY research suggests antibiotics may ward off heart trouble

Monday, September 3rd 2001, 12:00 am

By: News On 6

STOCKHOLM, Sweden (AP) _ Preliminary research suggests that prescribing antibiotics immediately after a heart attack or episode of severe chest pain might significantly reduce the chances of further attacks.

While doctors have long suspected that infections may cause heart trouble, the study is the first to indicate antibiotics may be helpful after a heart attack.

The study, to be presented Wednesday at the annual meeting of the European Society of Cardiology in Stockholm, found that the risk of further heart problems was 40 percent less in the group getting antibiotics than among those getting fake pills.

``It's too early to suggest that antibiotics are a solution to the problem because we may end up killing more patients than we save because of antibiotic resistance,'' said the study's leader, Dr. Juan Carlos Kaski, a professor of cardiovascular science at St. George's Hospital Medical School in London.

Dr. Maarten Simoons, a professor of cardiology at Erasmus University in Rotterdam, the Netherlands, said the results were encouraging.

``The next step would be to do 1,000 patients and see whether there's anything to it,'' said Simoons, who was not connected with the research.

Clogging of arteries is the problem underlying bad chest pain or a heart attack. Known as atherosclerosis, it is linked with inflammation. Some scientists believe inflammation may in part be triggered by infection.

Some have contended that heavy antibiotic use may partly explain the lower heart disease rates seen in Mediterranean countries.

Two germs suspected of contributing to artery clogging are chlamydia pneumoniae, which cause lung problems, and helicobacter pylori, which causes stomach ulcers.

``Half of us catch these infections during our childhood and then carry the bacteria for life without knowing,'' Kaski said.

Surprisingly, the antibiotics, which were designed to fight those two bugs, warded off further heart attacks and chest pain regardless of whether the patient carried either of the two infections.

``It may be that the antibiotics we used were working against a different infection altogether, or that the antibiotics may have a direct action on the walls of the coronary arteries, making them less inflamed and less likely to block,'' Kaski speculated.

In the study, which involved 324 people who were admitted to hospital with severe angina or their first heart attack, patients were divided into three groups.

Besides the usual heart drugs, one group was given a week's course of the common antibiotic axitromycin, which fights chlamydia, and a second group was prescribed amoxycillin, a popular medicine which targets the other bacteria. The third group was given dummy pills.

Tests showed that only about half the patients were infected with either of the two bacteria.

After a year, the two antibiotics groups had fared better than the one on fake pills. The two medications seemed to be equally effective, even on those people who were not carrying the bacteria.

There were 40 percent fewer readmissions to hospitals for heart attacks, chest pain episodes or emergency artery widening procedures in the antibiotics groups combined, compared with the other patients.

One of the problems with using antibiotics to ward off heart attacks is the danger of bacteria becoming increasingly immune to medication. The bacteria can cause life-threatening infections.