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Cardiac Risk Factor

Low-Dose Doxycycline Lowers C-Reactive Protein in CAD
By Bruce Jancin
Mar 13, 2003, 10:12pm

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CHICAGO � Low-dose doxycycline reduced levels of C-reactive protein and other markers of inflammation in patients with coronary artery disease, Dr. David L. Brown said at the annual scientific sessions of the American Heart Association.

In the randomized, double-blind Metalloproteinase Inhibition With Low-Dose Doxycycline to Prevent Acute Coronary Syndromes (MIDAS) pilot trial, 30 patients with symptomatic coronary artery disease received 6 months of doxycycline or placebo, said Dr. Brown, director of interventional cardiology at Beth Israel Medical Center, New York.

In the trial, sponsored by CollaGenex Pharmaceuticals Inc., patients received 20 mg b.i.d. of doxycycline hyclate (Periostat), a drug approved for dental use in combination with scaling and root planing as a treatment for advanced gum disease. At the low doses used, it has no antimicrobial effect but suppresses tumor necrosis factor� and other inflammatory cytokines, and inhibits tissue-destroying enzymes, especially matrix metalloproteinases (MMPs). In addition to causing gum disease, MMPs thin the fibrous cap overlying atheromatous plaque, thereby increasing the risks of acute MI and unstable angina in patients with coronary artery disease.

At 6 months, high-sensitivity C-reactive protein levels fell from 4.8 to 2.6 �g/mL levels in doxycycline-treated patients but were unchanged in the placebo group.

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