Acute coronary syndrome in human immunodeficiency virus-infected patients: characteristics and 1 year prognosis

Boccara, Franck; Mary‐Krause, Murielle; Teiger, Emmanuel; Lang, Sylvie; Lim, Pascal; Wahbi, Karim; Beygui, Farzin; Milleron, Olivier; Steg, Philippe Gabríel; Funck‐Brentano, Christian; Slama, Michel; Girard, Pierre Marie; Costagliola, Dominique; Cohen, Ariel

doi:10.1093/eurheartj/ehq372

Cited by 102 publications

(111 citation statements)

References 25 publications

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“…2 The proportions of dyslipidemic patients in the 2 groups in the present study were similar to those in the study by Hsue et al, 13 but the present study was unable to differentiate between hypercholesterolemia and hypertriglyceridemia. Nevertheless, Boccara et al 12 and Hsue et al 13 showed a higher frequency of hypertriglyceridemia in infected patients but similar cholesterol levels. In the present study, the percentage of STEMI was 90% in HIV-infected patients, and previous studies have reported similar rates.…”

Section: Discussionmentioning

confidence: 93%

“…[11][12][13][14][15]17 However, only 4 of those studies included a control group of uninfected patients, [12][13][14]17 and only 2 of the studies 12,14 matched the 2 groups for age, sex, and type of MI. In the present study, the prevalence of diabetes mellitus and hypertension was lower in HIV patients than in non-HIVinfected patients, and these results are in agreement with 2 other studies by Boccara et al 12 and Hsue et al, 13 who found similar values (20% and 10%, respectively). With regard to comorbidities, atrial fibrillation was less common among HIVinfected patients, probably because of their age and the lower prevalence of hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, the percentage of STEMI was 90% in HIV-infected patients, and previous studies have reported similar rates. 12 The young age of people with HIV explains this trend, and Rosengren et al 23 demonstrated an inverse association between age and the likelihood of the AMI being an STEMI. The proportion of patients undergoing PCI during the acute phase was roughly similar (66.4% versus 61.7%, P=0.047) in the 2 groups in the matched cohort and was close to that reported by Boccara et al 12 Moreover, there was no significant difference in the rate of overall revascularization (PCI or coronary artery bypass grafting; HIV 66.8% versus no HIV 62.7%, P=0.094).…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14][15] These studies demonstrated that HIVinfected patients had the same treatment at the acute phase, but that the rates of recurrent AMI and urgent percutaneous coronary intervention (PCI) during follow-up were higher than in HIV-uninfected patients. Unfortunately, in-hospital mortality could not be studied because there were too few patients (between 20 and 103).…”

Section: Clinical Perspective On P 1774mentioning

confidence: 99%

“…Unfortunately, in-hospital mortality could not be studied because there were too few patients (between 20 and 103). [11][12][13][14][15][16][17] The main objective of the present study was to determine the influence of HIV infection on in-hospital mortality within a large national cohort of patients with AMI. The second objective was to compare the 1-year prognosis in HIV-infected patients with that in HIVuninfected patients.…”

Section: Clinical Perspective On P 1774mentioning

confidence: 99%

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Outcomes After Acute Myocardial Infarction in HIV-Infected Patients

et al. 2013

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Background— We aimed to assess in-hospital case fatality and 1-year prognosis in HIV-infected patients with acute myocardial infarction. Methods and Results— From the PMSI (Program de Medicalisation des Systèmes d’informatique) database, data from 277 303 consecutive acute myocardial infarction patients hospitalized from January 1, 2005, to December 31, 2009, were analyzed. Surviving patients were followed up for 1 year after discharge. HIV-infected patients were compared with uninfected patients. Among the cohort, HIV-infected patients (n=608) accounted for 0.22%. All-cause hospital and 1-year mortality rates were lower in the HIV-infected group than in uninfected patients (3.1% versus 8.1% [ P <0.001] and 1.4% versus 5.5% [ P <0.001], respectively). From the database, we then analyzed a cohort derived from a matching procedure, with 1 HIV patient matched with 2 patients without HIV, based on age and sex (n=1824). Ischemic cardiomyopathy was more frequent in the HIV group (7.6% versus 4.2%, P =0.003). Hospitalization and 1-year mortality rates were similar in the 2 groups (3.1% versus 2.1% [ P =0.168] and 1.4% versus 1.7% [ P =0.642], respectively). However, at 12 months, hospitalizations for episodes of heart failure were significantly more frequent in HIV-infected than in uninfected patients (3.3% versus 1.4%, respectively; P =0.020). HIV infection, diabetes mellitus, history of ischemic cardiomyopathy, and undergoing percutaneous coronary intervention were associated in univariate analysis with occurrence of heart failure. By multivariable analysis, HIV infection (odds ratio 2.82, 95% confidence interval 1.32–6.01), diabetes mellitus, and undergoing percutaneous coronary intervention remained independent predictors of heart failure. Conclusions— The present study demonstrates that after acute myocardial infarction, HIV status influences long-term risk, although the short-term risk in HIV patients is comparable to that in uninfected patients.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Clinical Perspective On P 1774mentioning

confidence: 99%

Section: Clinical Perspective On P 1774mentioning

confidence: 99%

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Outcomes After Acute Myocardial Infarction in HIV-Infected Patients

et al. 2013

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Clinical Outcomes After Acute Coronary Syndromes or Revascularization Among People Living With HIV

Haji,

Capilupi,

Kwok

et al. 2024

JAMA Netw Open

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ImportanceClinical outcomes after acute coronary syndromes (ACS) or percutaneous coronary interventions (PCIs) in people living with HIV have not been characterized in sufficient detail, and extant data have not been synthesized adequately.ObjectiveTo better characterize clinical outcomes and postdischarge treatment of patients living with HIV after ACS or PCIs compared with patients in an HIV-negative control group.Data SourcesOvid MEDLINE, Embase, and Web of Science were searched for all available longitudinal studies of patients living with HIV after ACS or PCIs from inception until August 2023.Study SelectionIncluded studies met the following criteria: patients living with HIV and HIV-negative comparator group included, patients presenting with ACS or undergoing PCI included, and longitudinal follow-up data collected after the initial event.Data Extraction and SynthesisData extraction was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Clinical outcome data were pooled using a random-effects model meta-analysis.Main Outcome and MeasuresThe following clinical outcomes were studied: all-cause mortality, major adverse cardiovascular events, cardiovascular death, recurrent ACS, stroke, new heart failure, total lesion revascularization, and total vessel revascularization. The maximally adjusted relative risk (RR) of clinical outcomes on follow-up comparing patients living with HIV with patients in control groups was taken as the main outcome measure.ResultsA total of 15 studies including 9499 patients living with HIV (pooled proportion [range], 76.4% [64.3%-100%] male; pooled mean [range] age, 56.2 [47.0-63.0] years) and 1 531 117 patients without HIV in a control group (pooled proportion [range], 61.7% [59.7%-100%] male; pooled mean [range] age, 67.7 [42.0-69.4] years) were included; both populations were predominantly male, but patients living with HIV were younger by approximately 11 years. Patients living with HIV were also significantly more likely to be current smokers (pooled proportion [range], 59.1% [24.0%-75.0%] smokers vs 42.8% [26.0%-64.1%] smokers) and engage in illicit drug use (pooled proportion [range], 31.2% [2.0%-33.7%] drug use vs 6.8% [0%-11.5%] drug use) and had higher triglyceride (pooled mean [range], 233 [167-268] vs 171 [148-220] mg/dL) and lower high-density lipoprotein-cholesterol (pooled mean [range], 40 [26-43] vs 46 [29-46] mg/dL) levels. Populations with and without HIV were followed up for a pooled mean (range) of 16.2 (3.0-60.8) months and 11.9 (3.0-60.8) months, respectively. On postdischarge follow-up, patients living with HIV had lower prevalence of statin (pooled proportion [range], 53.3% [45.8%-96.1%] vs 59.9% [58.4%-99.0%]) and β-blocker (pooled proportion [range], 54.0% [51.3%-90.0%] vs 60.6% [59.6%-93.6%]) prescriptions compared with those in the control group, but these differences were not statistically significant. There was a significantly increased risk among patients living with HIV vs those without HIV for all-cause mortality (RR, 1.64; 95% CI, 1.32-2.04), major adverse cardiovascular events (RR, 1.11; 95% CI, 1.01-1.22), recurrent ACS (RR, 1.83; 95% CI, 1.12-2.97), and admissions for new heart failure (RR, 3.39; 95% CI, 1.73-6.62).Conclusions and RelevanceThese findings suggest the need for attention toward secondary prevention strategies to address poor outcomes of cardiovascular disease among patients living with HIV.

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Safety and long‐term outcomes after percutaneous coronary intervention in patients with human immunodeficiency virus

Badr

Minha

Kitabata

et al. 2014

Cathet Cardio Intervent

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Acute coronary syndrome in human immunodeficiency virus-infected patients: characteristics and 1 year prognosis

Abstract: These results suggest that the acute management of ACS in HIV-infected patients can routinely be the same as that of HIV-uninfected patients, but that specific secondary prevention measures are needed to alleviate the increased risk of recurrent ACS.

Cited by 102 publications

References 25 publications

Outcomes After Acute Myocardial Infarction in HIV-Infected Patients

Outcomes After Acute Myocardial Infarction in HIV-Infected Patients

Clinical Outcomes After Acute Coronary Syndromes or Revascularization Among People Living With HIV

Safety and long‐term outcomes after percutaneous coronary intervention in patients with human immunodeficiency virus

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