Widely Used Antibiotics May Raise Heart Risks, Review Finds

A widely used class of antibiotics is associated with a small but measurable increased risk of sudden cardiac death, researchers report. These antibiotics -- called macrolides -- are used to treat infections such as pneumonia, bronchitis and some sexually transmitted diseases. In the new report, the investigators analyzed 33 studies that were conducted between 1966 and 2015, and included a total of more than 20 million patients. The studies compared patients who took macrolides, other types of antibiotics, or no antibiotics. Macrolides include the antibiotics erythromycin, azithromycin, clarithromycin and quinolone. The results revealed a small, but statistically significant, association between taking macrolides and increased risk of sudden cardiac death. But the review did not prove a cause-and-effect relationship between these medications and sudden cardiac death. The study was published Nov. 9 in the Journal of the American College of Cardiology. "The absolute risks of sudden cardiac death and cardiac death are small, so it should likely have limited effect on prescribing practice," study author said. "However, given that macrolides are one of the most commonly used antibiotic groups, and millions of patients are prescribed these drugs annually, the total number of sudden cardiac deaths or ventricular tachyarrhythmias and cardiac deaths may not be negligible," study author added. An average of 80 cases of rapid heartbeat that can result in sudden cardiac death (or "ventricular tachyarrhythmias") occurred per 1 million treatment courses among patients who were not taking macrolides, the investigators found. But, current use of macrolides was associated with an additional 118 ventricular tachyarrhythmias or related sudden cardiac deaths per 1 million treatment courses. And there were 36 additional sudden cardiac deaths from causes other than ventricular tachyarrhythmia, and 38 additional heart-related deaths per one million treatment courses, the findings showed. Past use of macrolides and use of other antibiotics were not associated with increased heart risk, the researchers found.

Return to top

                                                               Arm Artery Access Safer For Angioplasty, Review Finds

For patients experiencing heart attacks or severe chest pain, it is safer to access blocked vessels through an arm artery rather than a groin artery, a new analysis finds. After reviewing four international trials involving more than 17,000 patients, the Italian researchers found that 27 percent fewer patients died when their vessel-opening angioplasties were performed via the arm artery. And more than 40 percent fewer major bleeding events were recorded in this group when compared to the groin artery group, according to the meta-analysis, published Nov. 10 in the Annals of Internal Medicine. "I was not surprised, as several previous trials and pooled analyses had already suggested that radial access reduces access site-related major bleeding and that this occurrence may ultimately reduce mortality," study author said. "These pooled data, given such a clinically relevant mortality benefit, may represent the best incentive for centers to support the transition towards radial access," he added. Widely embraced in Europe, Canada and Asia, the arm artery approach has been used for more than two decades to diagnose and treat heart disease, including angioplasty procedures to open blocked blood vessels. About 16 percent of heart catheterization procedures in the United States use the arm artery instead of the groin artery, according to 2012 statistics. Study author and his team compared clinical outcomes with arm access versus groin access in thousands of patients with acute coronary syndrome, an emergency situation that includes heart attacks and unstable angina. In addition to the benefits in reducing death and bleeding risks, the review showed a 14 percent reduced risk of major complications in arm artery patients compared to the groin artery group. But because arm artery procedures use a smaller vessel, they lasted slightly longer than groin artery procedures and came with higher risks for "access-site crossover," meaning the procedure needed to be finished through another access point. 

Return to top

                                              Breast-Feeding Linked To Reduced Risk Of Preemie Eye Problem

Breast-feeding a premature infant may help reduce the risk of a serious eye problem known as retinopathy of prematurity (ROP), new research suggests. The researchers said that when babies were exclusively fed breast milk, the risk of any-stage ROP appeared to drop by about 75 percent. And the risk of severe ROP seemed to be reduced by 90 percent, the researchers added. For the study, researchers reanalyzed the results of five published studies on ROP. The studies included more than 2,200 preterm infants, comparing how often babies had been fed human milk or formula, and whether or not they developed ROP. However, the new analysis only showed an association between breast milk and a reduced risk of ROP. It did not prove a cause-and-effect relationship due to the study's design. Results of the study were published online Nov. 16 in Pediatrics. Extremely preterm babies are most at risk of ROP. In the United States, 59 percent of babies born at 22 to 28 weeks have the disorder, said study researcher. He added that in China, a previous study showed the incidence of ROP was 50 percent in infants with a birth weight under 1,000 grams (2.2 pounds). ROP "has become a leading cause of childhood blindness in recent time," he added. "In general, there are more ROP cases in developed countries, but more severe cases and higher rates of blindness in developing countries." The greater incidence of ROP is likely due to the increasing survival rate of very preterm babies in developed countries, according to researcher. In developing countries, preterm babies are less likely to survive. When they do, the screening and treatments are not as good, he said, so blindness may be more likely. Babies in the studies had a range of gestational ages, from 26 to about 30 weeks. Their weights ranged from about 1.7 pounds to about 3 pounds. No information was given about how long the breast-feeding continued. In re-evaluating the studies, research team found that breast-feeding in any amount appeared to reduce the risk of ROP. And it appeared that the more breast milk, the better. Exclusive breast-feeding seemed to drop the odds of ROP by 75 percent compared to exclusive formula use. And any breast-feeding appeared to reduce the odds of the serious eye disease by 46 percent, the research showed. How might human milk offer protection from the eye disorder? The antioxidants in human milk may help, study author said. Human milk also has immune-protective properties, the researchers said. Breast-feeding also seems to help prevent two conditions known as sepsis and necrotizing enterocolitis that may require oxygen therapy, which has also been linked to a higher risk of ROP, the study authors said.

Return to top

                                                                                   Belly Fat Is Bad, Even At A Normal Weight

Can belly fat be a problem even for people who aren't overweight? New research says yes, excess weight around the middle boosts the risk of premature death even for people considered normal weight. What's more, normal weight people with excess stomach fat had an even higher risk of dying early than overweight or obese people did, according to new research published online Nov. 10 in the Annals of Internal Medicine. For the study, a research team used data from a national survey to compare the risk of premature death among more than 15,000 adults. The mean follow-up time was 14 years. The researchers looked at body mass index (BMI), a rough estimate of body fat based on weight and height measurements. They also looked at waist-to-hip ratios. The investigators found that normal weight adults with extra stomach fat had the worst long-term survival, regardless of BMI. And, normal weight men with bigger bellies seemed to fare even worse than slender women with more tummy fat. A normal weight male with more fat around the waist had an 87 percent increased risk of death during the study period compared to a man who was normal weight without extra belly fat. Compared to overweight or obese men, a normal weight man with extra belly fat had more than twice the risk of dying early, the study revealed. Normal weight women with extra belly fat had nearly a 50 percent increased risk of death during the study period versus a normal weight woman whose weight was more equally distributed throughout her body. Compared to obese women, the normal weight women with belly fat had a 32 percent higher risk of early death, the researchers found.

Return to top

                                                   Newborn Probiotic Use Tied To Lower Risk Of Type 1 Diabetes

Adding probiotics -- good bacteria -- to an infant's feedings in the first month of life may reduce the risk of type 1 diabetes mellitus (DM) for those genetically predisposed to getting the disease, new research suggests. Supplementing with probiotics later in infancy didn't seem to confer the same benefit, the researchers noted. "Early probiotic exposure during the first 27 days is associated with a decreased risk of type 1 diabetes among those who have the highest genetic risk of type 1 diabetes," said lead researcher. However, researcher noted that because of the study's design, the researchers "cannot make a conclusion about causality." But she stressed that the association was so strong, these findings warrant further study. The study was published in the Nov. 9 issue of JAMA Pediatrics. What triggers type 1 diabetes is unclear. A number of genes are suspect, but experts believe an environmental trigger also plays a role. One possible trigger is an imbalance in the bacteria in the gut may help fuel the autoimmune attack, the researchers said. To explore this idea further, the researchers looked at an ongoing prospective study from six medical centers -- three in the United States and three in Europe. The final study sample included nearly 7,500 children between 4 and 10 years old. Blood samples were taken every three months from age 3 months to 48 months to detect signs of type 1 diabetes. Samples were taken every six months after that. Parents completed questionnaires and food diaries to detail infant feeding and probiotic supplement use from birth to 3 months. Mothers provided information on their diets during pregnancy as well. Probiotics are live bacteria thought to help maintain a healthy digestive system. In Europe, probiotic use is more common than in the United States, the study indicates. Babies received probiotics through infant formula or through a liquid dietary supplement, she added. "In general, probiotics are considered safe," she said. "There are no reports that among healthy children there would be any adverse outcomes from probiotics." The researchers found that probiotic use in the first 27 days is linked to reduced odds of type 1 diabetes by 60 percent for children with the highest risk of developing the disease. These children have the genotype called DR3/4, the study said. Children without that genetic makeup didn't benefit from the early probiotics. And no one seemed to benefit from later probiotic use, the researchers said. So, should parents with a family history of type 1 diabetes start giving their babies probiotics? "It's too early in the research to give any recommendations," researcher said. But, she added, if it is known that child is at higher risk, one might ask child's doctor about supplementing with probiotics early in the baby's life.

Return to top