Evidence Based Snapshots

The Journal of Informed Pharmacotherapy 2004;15:150.

Azithromycin for the Secondary Prevention of Coronary Heart Disease Events: The WIZARD Study

Reviewer: James McCormack, B.Sc. (Pharm), Pharm. D.
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Associate Editor, Journal of Informed Pharmacotherapy

Original Citation

Azithromycin for the secondary prevention of coronary heart disease events: the WIZARD study: a randomized controlled trial. O'Connor CM, Dunne MW, Pfeffer MA, Muhlestein JB, Yao L, Gupta S, Benner RJ, Fisher MR, Cook TD; Investigators in the WIZARD Study.  JAMA 2003;290:1459-66 PubMed Citation

Overall Study Question

These investigators compared a 12-week course of azithromycin to placebo in patients with stable coronary artery disease.


7747 patients with a history of myocardial infarction and a C pneumoniae IgG titer of 1:16 or more. Fifty-one percent had angina and 17% were smokers. Post-MI therapy prior to study enrollment included aspirin (87%), ACE inhibitors (42%), beta-blockers (60%), and statins (60%). The average age of the patients was 62 years and 18% were female. 


Patients were randomized in a blinded fashion to receive either azithromycin (600 mg PO daily for three days then weekly) or placebo for 12 weeks. 


The median study duration follow-up was 14 months.


There was no difference between groups in the primary end point or any of its components; death, recurrent MI, revascularizations, or hospitalizations for angina. Azithromycin did produce a 9% absolute increase in the chance of diarrhea. 

How does this study contribute to the drug therapy of patients with coronary artery disease?

This study suggests that in patients with stable coronary artery disease, a 12 week course of azithromycin did not have an impact on coronary heart disease-related events.

Copyright © 2004 by the Journal of Informed Pharmacotherapy. All rights reserved.