Azithromycin and Risk of Cardiovascular Death: A Meta-Analytic Review of Observational Studies

American Journal of Therapeutics
Aref A Bin AbdulhakAlan P Wimmer

Abstract

Recent evidence, though conflicting, suggests an association between azithromycin use and cardiovascular death. We conducted a systematic review and meta-analysis to evaluate the effect of azithromycin on risk of death. Multiple databases were searched. Authors independently screened and extracted the data from studies. Primary outcome of interest was risk of death (cardiovascular and/or noncardiovascular). Subgroup analyses were conducted to explore the source of a possible heterogeneity. Random effects model meta-analysis and hazards ratio (HR) were used to pool the data and calculate the overall effect estimate, respectively. Eight hundred twenty-eight citations, identified with 5 cohort studies that involved 2,246,178 episodes of azithromycin use, met our inclusion criteria. Azithromycin use was not associated with higher risk of death from any cause, HR = 0.99 [confidence interval (CI), 0.82-1.19], I = 54%, or cardiovascular cause, HR = 1.15 (CI, 0.66-2.00), I = 64%, but there was a moderate degree of heterogeneity. Subgroup analyses have shown no increased risk of death with azithromycin use in younger population with zero degree of heterogeneity, HR = 0.85 (CI, 0.66-1.09), I = 0%. However, current use of azithromycin (wi...Continue Reading

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Citations

Dec 30, 2016·JAAPA : Official Journal of the American Academy of Physician Assistants·S Scott Sutton
Sep 30, 2017·Journal of Comparative Effectiveness Research·S Scott SuttonJames W Hardin
Jan 31, 2020·Circulation Research·Paolo VerdecchiaGianpaolo Reboldi
Jun 20, 2019·European Heart Journal·Yoriko HeianzaLu Qi
Aug 17, 2020·International Journal of Environmental Research and Public Health·Olga PappaAthena Mavridou
Aug 8, 2018·Therapeutic Advances in Ophthalmology·Kostas A KagkelarisGeorge D Panayiotakopoulos

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