CONTEXT: Metabolic changes and smoking are common among HIV patients and may confer increased cardiovascular risk. OBJECTIVE: The aim of the study was to determine acute myocardial infarction (AMI) rates and cardiovascular risk factors in HIV compared with non-HIV patients in two tertiary care hospitals. DESIGN, SETTING, AND PARTICIPANTS: We conducted a health care system-based cohort study using a large data registry with 3,851 HIV and 1,044,589 non-HIV patients. AMI rates were determined among patients receiving longitudinal care between October 1, 1996, and June 30, 2004. MAIN OUTCOME MEASURES: The primary outcome was myocardial infarction, identified by International Classification of Diseases coding criteria. RESULTS: AMI was identified in 189 HIV and 26,142 non-HIV patients. AMI rates per 1000 person-years were increased in HIV vs. non-HIV patients [11.13 (95% confidence interval [CI] 9.58-12.68) vs. 6.98 (95% CI 6.89-7.06)]. The HIV cohort had significantly higher proportions of hypertension (21.2 vs. 15.9%), diabetes (11.5 vs. 6.6%), and dyslipidemia (23.3 vs. 17.6%) than the non-HIV cohort (P < 0.0001 for each comparison). The difference in AMI rates between HIV and non-HIV patients was significant, with a relative risk (RR) of 1.75 (95% CI 1.51-2.02; P < 0.0001), adjusting for age, gender, race, hypertension, diabetes, and dyslipidemia. In gender-stratified models, the unadjusted AMI rates per 1000 person-years were higher for HIV patients among women (12.71 vs. 4.88 for HIV compared with non-HIV women), but not among men (10.48 vs. 11.44 for HIV compared with non-HIV men). The RRs (for HIV vs. non-HIV) were 2.98 (95% CI 2.33-3.75; P < 0.0001) for women and 1.40 (95% CI 1.16-1.67; P = 0.0003) for men, adjusting for age, gender, race, hypertension, diabetes, and dyslipidemia. A limitation of this database is that it contains incomplete data on smoking. Smoking could not be included in the overall regression model, and some of the increased risk may be accounted for by differences in smoking rates. CONCLUSIONS: AMI rates and cardiovascular risk factors were increased in HIV compared with non-HIV patients, particularly among women. Cardiac risk modification strategies are important for the long-term care of HIV patients.
CONTEXT: Metabolic changes and smoking are common among HIV patients and may confer increased cardiovascular risk. OBJECTIVE: The aim of the study was to determine acute myocardial infarction (AMI) rates and cardiovascular risk factors in HIV compared with non-HIV patients in two tertiary care hospitals. DESIGN, SETTING, AND PARTICIPANTS: We conducted a health care system-based cohort study using a large data registry with 3,851 HIV and 1,044,589 non-HIV patients. AMI rates were determined among patients receiving longitudinal care between October 1, 1996, and June 30, 2004. MAIN OUTCOME MEASURES: The primary outcome was myocardial infarction, identified by International Classification of Diseases coding criteria. RESULTS: AMI was identified in 189 HIV and 26,142 non-HIV patients. AMI rates per 1000 person-years were increased in HIV vs. non-HIV patients [11.13 (95% confidence interval [CI] 9.58-12.68) vs. 6.98 (95% CI 6.89-7.06)]. The HIV cohort had significantly higher proportions of hypertension (21.2 vs. 15.9%), diabetes (11.5 vs. 6.6%), and dyslipidemia (23.3 vs. 17.6%) than the non-HIV cohort (P < 0.0001 for each comparison). The difference in AMI rates between HIV and non-HIV patients was significant, with a relative risk (RR) of 1.75 (95% CI 1.51-2.02; P < 0.0001), adjusting for age, gender, race, hypertension, diabetes, and dyslipidemia. In gender-stratified models, the unadjusted AMI rates per 1000 person-years were higher for HIV patients among women (12.71 vs. 4.88 for HIV compared with non-HIV women), but not among men (10.48 vs. 11.44 for HIV compared with non-HIV men). The RRs (for HIV vs. non-HIV) were 2.98 (95% CI 2.33-3.75; P < 0.0001) for women and 1.40 (95% CI 1.16-1.67; P = 0.0003) for men, adjusting for age, gender, race, hypertension, diabetes, and dyslipidemia. A limitation of this database is that it contains incomplete data on smoking. Smoking could not be included in the overall regression model, and some of the increased risk may be accounted for by differences in smoking rates. CONCLUSIONS: AMI rates and cardiovascular risk factors were increased in HIV compared with non-HIV patients, particularly among women. Cardiac risk modification strategies are important for the long-term care of HIV patients.
Authors: P Maggi; G Serio; G Epifani; G Fiorentino; A Saracino; C Fico; F Perilli; A Lillo; S Ferraro; M Gargiulo; A Chirianni; G Angarano; G Regina; G Pastore Journal: AIDS Date: 2000-11-10 Impact factor: 4.177
Authors: J H Stein; M A Klein; J L Bellehumeur; P E McBride; D A Wiebe; J D Otvos; J M Sosman Journal: Circulation Date: 2001-07-17 Impact factor: 29.690
Authors: K A Lichtenstein; D J Ward; A C Moorman; K M Delaney; B Young; F J Palella; P H Rhodes; K C Wood; S D Holmberg Journal: AIDS Date: 2001-07-27 Impact factor: 4.177
Authors: C Hadigan; J B Meigs; C Corcoran; P Rietschel; S Piecuch; N Basgoz; B Davis; P Sax; T Stanley; P W Wilson; R B D'Agostino; S Grinspoon Journal: Clin Infect Dis Date: 2000-12-15 Impact factor: 9.079
Authors: Samuel A Bozzette; Christopher F Ake; Henry K Tam; Sophia W Chang; Thomas A Louis Journal: N Engl J Med Date: 2003-02-20 Impact factor: 91.245
Authors: Sharon A Riddler; Ellen Smit; Stephen R Cole; Rui Li; Joan S Chmiel; Adrian Dobs; Frank Palella; Barbara Visscher; Rhobert Evans; Lawrence A Kingsley Journal: JAMA Date: 2003-06-11 Impact factor: 56.272
Authors: Colleen Hadigan; James B Meigs; Peter W F Wilson; Ralph B D'Agostino; Benjamin Davis; Nesli Basgoz; Paul E Sax; Steven Grinspoon Journal: Clin Infect Dis Date: 2003-03-20 Impact factor: 9.079
Authors: Rebeccah A McKibben; Joseph B Margolick; Steven Grinspoon; Xiuhong Li; Frank J Palella; Lawrence A Kingsley; Mallory D Witt; Richard T George; Lisa P Jacobson; Matthew Budoff; Russell P Tracy; Todd T Brown; Wendy S Post Journal: J Infect Dis Date: 2014-10-30 Impact factor: 5.226
Authors: John R Koethe; Aihua Bian; Ayumi K Shintani; M Sean Boger; Valerie J Mitchell; Husamettin Erdem; Todd Hulgan Journal: AIDS Res Hum Retroviruses Date: 2012-02-02 Impact factor: 2.205
Authors: Tracie L Miller; Gabriel Somarriba; E John Orav; Armando J Mendez; Daniela Neri; Natasha Schaefer; Lourdes Forster; Ronald Goldberg; Gwendolyn B Scott; Steven E Lipshultz Journal: J Acquir Immune Defic Syndr Date: 2010-10 Impact factor: 3.731
Authors: Cleophas Chimbetete; Catrina Mugglin; Tinei Shamu; Bindu Kalesan; Barbara Bertisch; Matthias Egger; Olivia Keiser Journal: Trop Med Int Health Date: 2017-06-08 Impact factor: 2.622
Authors: Shannon G Loelius; Katie L Lannan; Neil Blumberg; Richard P Phipps; Sherry L Spinelli Journal: Thromb Res Date: 2018-07-06 Impact factor: 3.944
Authors: Martin Tibuakuu; Di Zhao; Ankita Saxena; Todd T Brown; Lisa P Jacobson; Frank J Palella; Mallory D Witt; Susan L Koletar; Joseph B Margolick; Eliseo Guallar; Sai Krishna C Korada; Matthew J Budoff; Wendy S Post; Erin D Michos Journal: J Cardiovasc Comput Tomogr Date: 2018-01-31