Rationale and Design of a Secondary Prevention Trial of Antibiotic Use in Patients After Myocardial Infarction: The WIZARD (Weekly Intervention With Zithromax [Azithromycin] for Atherosclerosis and Its Related Disorders) Trial

J Infect Dis. 2000 Jun;181 Suppl 3:S572-8. doi: 10.1086/315634.


Mounting evidence supports the contention that atherosclerosis is an inflammatory disease. Recently a possible role for infectious microorganisms has gathered attention. Chlamydia pneumoniae is one possible pathogen. If C. pneumoniae is a target organism, antibiotics with antichlamydial activity may be able to ameliorate plaque instability. The WIZARD trial is a secondary prevention study that is assessing the impact of a 3-month course of azithromycin compared with placebo on the progression of clinical coronary heart disease. The study will enroll 3300 patients who have had a prior myocardial infarction and who have a C. pneumoniae IgG titer of >/=1:16. The primary end point is a composite of time to either recurrent myocardial infarction, death, a revascularization procedure, or hospitalization for angina. This study is the first of a series of adequately powered clinical trials that will attempt to bridge insights from preclinical investigations to interventions applicable to patient care.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Azithromycin / therapeutic use*
  • Chlamydia Infections / complications
  • Chlamydia Infections / drug therapy*
  • Chlamydophila pneumoniae*
  • Coronary Artery Disease / drug therapy*
  • Coronary Artery Disease / microbiology
  • Coronary Disease / drug therapy
  • Humans
  • Myocardial Infarction / drug therapy*
  • Randomized Controlled Trials as Topic / methods*
  • Research Design
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Azithromycin