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Background It is unclear whether HIV infection affects the long‐term prognosis after an acute coronary syndrome (ACS). The objective of the current study was to compare rates of major adverse cardiac and cerebrovascular events after a first ACS between people living with HIV (PLHIV) and HIV‐uninfected (HIV−) patients, and to identify determinants of cardiovascular prognosis. Methods and Results Consecutive PLHIV and matched HIV− patients with a first episode of ACS were enrolled in 23 coronary intensive care units in France. Patients were matched for age, sex, and ACS type. The primary end point was major adverse cardiac and cerebrovascular events (cardiac death, recurrent ACS, recurrent coronary revascularization, and stroke) at 36‐month follow‐up. A total of 103 PLHIV and 195 HIV− patients (mean age, 49 years [SD, 9 years]; 94.0% men) were included. After a mean of 36.6 months (SD, 6.1 months) of follow‐up, the risk of major adverse cardiac and cerebrovascular events was not statistically significant between PLHIV and HIV− patients (17.8% and 15.1%, P =0.22; multivariable hazard ratio [HR], 1.60; 95% CI, 0.67–3.82 [ P =0.29]). Recurrence of ACS was more frequent among PLHIV (multivariable HR, 6.31; 95% CI, 1.32–30.21 [ P =0.02]). Stratified multivariable Cox models showed that HIV infection was the only independent predictor for ACS recurrence. PLHIV were less likely to stop smoking (47% versus 75%; P =0.01) and had smaller total cholesterol decreases (–22.3 versus –35.0 mg/dL; P =0.04). Conclusions Although the overall risk of major adverse cardiac and cerebrovascular events was not statistically significant between PLHIV and HIV− individuals, PLHIV had a higher rate of recurrent ACS. Registration URL: https://www.clini​caltr​ials.gov ; Unique identifier: NCT00139958.

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Abstract:This study presents an analysis of the bias introduced by using simplified methods to calculate food intake of fish from stomach contents. Three sources of bias were considered: (1) The effect of estimating consumption based on a limited number of stomach samples, (2) the effect of using average stomach contents derived from pooled stomach samples rather than individual stomachs and (3) the effect of ignoring 5 biological factors which affect the evacuation of prey. Estimating consumption from only two stomach samples provided results close to the actual intake rate in a simulation study. In contrast to this, serious positive bias was introduced by estimating food intake from the contents of pooled stomach samples. An expression is given which can be used to correct analytically for this bias. A new method which 10 takes account of the distribution and evacuation of individual prey types as well as the effect of other food in the stomach on evacuation is suggested for the estimation of the intake of separate prey types. Simplifying the estimation by ignoring these factors biased consumption estimates of individual prey by up to 150% in a data example. 15