Jason J Sico1, Chung-Chou H Chang2, Kaku So-Armah2, Amy C Justice2, Elaine Hylek2, Melissa Skanderson2, Kathleen McGinnis2, Lewis H Kuller2, Kevin L Kraemer2, David Rimland2, Matthew Bidwell Goetz2, Adeel A Butt2, Maria C Rodriguez-Barradas2, Cynthia Gibert2, David Leaf2, Sheldon T Brown2, Jeffrey Samet2, Lewis Kazis2, Kendall Bryant2, Matthew S Freiberg2. 1. From the VA Connecticut Health Care System (J.J.S., A.C.J., M.S., K.M.), West Haven Veterans Administration Medical Center, West Haven; Yale University School of Medicine (J.J.S., K.S.-A., A.C.J.), New Haven, CT; University of Pittsburgh School of Medicine (C.-C.H.C., K.L.K., A.A.B.); University of Pittsburgh Graduate School of Public Health (C.-C.H.C., L.H.K.), Pittsburgh, PA; Boston Medical Center (E.H.), MA; Emory University School of Medicine and Atlanta Veterans Administration Medical Center (D.R.), Atlanta, GA; David Geffen School of Medicine at UCLA and the VA Greater Los Angeles Health Care System (M.B.G., D.L.), Los Angeles, CA; VA Pittsburgh Health Care System (A.A.B.), Pittsburgh, PA; Michael E. DeBakey Veterans Administration Medical Center and Baylor College of Medicine (M.C.R.-B.), Houston, TX; Washington DC Veterans Administration Medical Center and George Washington University School of Medicine (C.G.), Washington, DC; James J. Peters VA (S.T.B.), Bronx; Mount Sinai School of Medicine (S.T.B.), New York, NY; Boston University School of Medicine (J.S.), MA; Center for the Assessment of Pharmaceutical Practices (L.K.), Department of Health Policy and Management, Boston University School of Public Health; Center for Healthcare Organization and Implementation Research (L.K.), a Center for Innovation, Veterans Administration Medical Center, Bedford, MA; National Institute on Alcohol Abuse and Alcoholism (K.B.), Bethesda, MD; and Vanderbilt University School of Medicine and the Nashville Veterans Affairs Medical Center (M.S.F.), Nashville, TN. jason.sico@va.gov. 2. From the VA Connecticut Health Care System (J.J.S., A.C.J., M.S., K.M.), West Haven Veterans Administration Medical Center, West Haven; Yale University School of Medicine (J.J.S., K.S.-A., A.C.J.), New Haven, CT; University of Pittsburgh School of Medicine (C.-C.H.C., K.L.K., A.A.B.); University of Pittsburgh Graduate School of Public Health (C.-C.H.C., L.H.K.), Pittsburgh, PA; Boston Medical Center (E.H.), MA; Emory University School of Medicine and Atlanta Veterans Administration Medical Center (D.R.), Atlanta, GA; David Geffen School of Medicine at UCLA and the VA Greater Los Angeles Health Care System (M.B.G., D.L.), Los Angeles, CA; VA Pittsburgh Health Care System (A.A.B.), Pittsburgh, PA; Michael E. DeBakey Veterans Administration Medical Center and Baylor College of Medicine (M.C.R.-B.), Houston, TX; Washington DC Veterans Administration Medical Center and George Washington University School of Medicine (C.G.), Washington, DC; James J. Peters VA (S.T.B.), Bronx; Mount Sinai School of Medicine (S.T.B.), New York, NY; Boston University School of Medicine (J.S.), MA; Center for the Assessment of Pharmaceutical Practices (L.K.), Department of Health Policy and Management, Boston University School of Public Health; Center for Healthcare Organization and Implementation Research (L.K.), a Center for Innovation, Veterans Administration Medical Center, Bedford, MA; National Institute on Alcohol Abuse and Alcoholism (K.B.), Bethesda, MD; and Vanderbilt University School of Medicine and the Nashville Veterans Affairs Medical Center (M.S.F.), Nashville, TN.
Abstract
OBJECTIVE: Given conflicting data regarding the association of HIV infection and ischemic stroke risk, we sought to determine whether HIV infection conferred an increased ischemic stroke risk among male veterans. METHODS: The Veterans Aging Cohort Study-Virtual Cohort consists of HIV-infected and uninfected veterans in care matched (1:2) for age, sex, race/ethnicity, and clinical site. We analyzed data on 76,835 male participants in the Veterans Aging Cohort Study-Virtual Cohort who were free of baseline cardiovascular disease. We assessed demographics, ischemic stroke risk factors, comorbid diseases, substance use, HIV biomarkers, and incidence of ischemic stroke from October 1, 2003, to December 31, 2009. RESULTS: During a median follow-up period of 5.9 (interquartile range 3.5-6.6) years, there were 910 stroke events (37.4% HIV-infected). Ischemic stroke rates per 1,000 person-years were higher for HIV-infected (2.79, 95% confidence interval 2.51-3.10) than for uninfected veterans (2.24 [2.06-2.43]) (incidence rate ratio 1.25 [1.09-1.43]; p < 0.01). After adjusting for demographics, ischemic stroke risk factors, comorbid diseases, and substance use, the risk of ischemic stroke was higher among male veterans with HIV infection compared with uninfected veterans (hazard ratio 1.17 [1.01-1.36]; p = 0.04). CONCLUSIONS: HIV infection is associated with an increased ischemic stroke risk among HIV-infected compared with demographically and behaviorally similar uninfected male veterans.
OBJECTIVE: Given conflicting data regarding the association of HIV infection and ischemic stroke risk, we sought to determine whether HIV infection conferred an increased ischemic stroke risk among male veterans. METHODS: The Veterans Aging Cohort Study-Virtual Cohort consists of HIV-infected and uninfected veterans in care matched (1:2) for age, sex, race/ethnicity, and clinical site. We analyzed data on 76,835 male participants in the Veterans Aging Cohort Study-Virtual Cohort who were free of baseline cardiovascular disease. We assessed demographics, ischemic stroke risk factors, comorbid diseases, substance use, HIV biomarkers, and incidence of ischemic stroke from October 1, 2003, to December 31, 2009. RESULTS: During a median follow-up period of 5.9 (interquartile range 3.5-6.6) years, there were 910 stroke events (37.4% HIV-infected). Ischemic stroke rates per 1,000 person-years were higher for HIV-infected (2.79, 95% confidence interval 2.51-3.10) than for uninfected veterans (2.24 [2.06-2.43]) (incidence rate ratio 1.25 [1.09-1.43]; p < 0.01). After adjusting for demographics, ischemic stroke risk factors, comorbid diseases, and substance use, the risk of ischemic stroke was higher among male veterans with HIV infection compared with uninfected veterans (hazard ratio 1.17 [1.01-1.36]; p = 0.04). CONCLUSIONS:HIV infection is associated with an increased ischemic stroke risk among HIV-infected compared with demographically and behaviorally similar uninfected male veterans.
Authors: Paul N Jensen; Karin Johnson; James Floyd; Susan R Heckbert; Ryan Carnahan; Sascha Dublin Journal: Pharmacoepidemiol Drug Saf Date: 2012-01 Impact factor: 2.890
Authors: Kathleen A McGinnis; Cynthia A Brandt; Melissa Skanderson; Amy C Justice; Shahida Shahrir; Adeel A Butt; Sheldon T Brown; Matthew S Freiberg; Cynthia L Gibert; Matthew Bidwell Goetz; Joon Woo Kim; Margaret A Pisani; David Rimland; Maria C Rodriguez-Barradas; Jason J Sico; Hilary A Tindle; Kristina Crothers Journal: Nicotine Tob Res Date: 2011-09-12 Impact factor: 4.244
Authors: Joseph S Ross; Greg Arling; Susan Ofner; Christianne L Roumie; Salomeh Keyhani; Linda S Williams; Diana L Ordin; Dawn M Bravata Journal: Stroke Date: 2011-06-30 Impact factor: 7.914
Authors: Matthew S Freiberg; Chung-Chou H Chang; Melissa Skanderson; Kathleen McGinnis; Lewis H Kuller; Kevin L Kraemer; David Rimland; Matthew B Goetz; Adeel A Butt; Maria C Rodriguez Barradas; Cynthia Gibert; David Leaf; Sheldon T Brown; Jeffrey Samet; Lewis Kazis; Kendall Bryant; Amy C Justice Journal: Circ Cardiovasc Qual Outcomes Date: 2011-06-28
Authors: Olaniyi James Ekundayo; Stefanie D Vassar; Linda S Williams; Dawn M Bravata; Eric M Cheng Journal: Stroke Date: 2011-05-05 Impact factor: 7.914
Authors: Felicia C Chow; Susan Regan; Steven Feske; James B Meigs; Steven K Grinspoon; Virginia A Triant Journal: J Acquir Immune Defic Syndr Date: 2012-08-01 Impact factor: 3.731
Authors: Matthew E Levy; Alan E Greenberg; Manya Magnus; Naji Younes; Amanda Castel Journal: AIDS Res Hum Retroviruses Date: 2018-11-27 Impact factor: 2.205