Cardiac events after using clarithromycin for anti-Helicobacter pylori therapy in patients with coronary artery disease

• Published in: Medicine (Baltimore) Vol. 102; no. 45; p. e35922
• Main Authors: Lin, Cheng-Kuan, Lee, Tzong-Hsi, Liao, Pen-Chih, Lin, Cheng-Lu
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins 10.11.2023
• Subjects: Anti-Bacterial Agents - adverse effects; Clarithromycin - adverse effects; Coronary Artery Disease - etiology; Drug Therapy, Combination; Helicobacter Infections - complications; Helicobacter Infections - drug therapy; Helicobacter pylori; Humans; Observational Study; Retrospective Studies
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000035922

Clarithromycin is an antibiotic commonly used to treat Helicobacter pylori infections. The US Food and Drug Administration (FDA) advises caution before prescribing clarithromycin to patients with cardiac diseases. This study aimed to evaluate cardiac events after anti-H pylori treatment in patients with coronary artery disease. A retrospective 5-year study was conducted on outpatients who received anti-H pylori therapy. Among the 7855 patients receiving therapy, 228 patients (2.9%) underwent angiography with coronary artery disease before therapy, and 193 patients received clarithromycin. Clarithromycin users seemed not to be at risk for cardiac events as compared with non-clarithromycin users at 3 months (4.7% vs 2.9%, P = .63) and 1 year (10.9% vs 5.7%, P = .35). Neither life-threatening dysrhythmia nor cardiac death was noted. The risk factors for cardiac events within 3 months after therapy were smoker (OR:5.38, 95% CI:1.39-20.78), and events within 1 year were smoker (OR:3.8, 95% CI:1.41-10.22), and diabetes mellitus (OR:5.68, 95% CI:1.9-16.98). Among patients with coronary artery disease who received anti-H pylori therapy, short-term cardiac events did not increase in clarithromycin users but should be considered in diabetic and smoking patients.