Inflammation, infection, or both in atherosclerosis: the ROXIS trial in perspective.

The role of infection in the instability of atherosclerotic plaques has been questioned because of discrepancies in the results of clinical trials that tested antibiotics in acute coronary syndromes. The results of the Randomized Trial of Roxithromycin in Non-Q-Wave Coronary Syndromes (ROXIS) are summarized and contrasted with two other pilot studies of antibiotic therapy of coronary artery disease. Relevant characteristics of patients enrolled and rationales for these trials are discussed and serologic results are presented.