Acute myocardial infarction in patients infected with human immunodeficiency virus

Varriale, Philip; Saravi, G; Hernandez, Eliezer; Carbon, Francisco

doi:10.1016/j.ahj.2003.07.007

Cited by 61 publications

(44 citation statements)

References 39 publications

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“…[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: 98%

“…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: Clinical Perspective On P 1774mentioning

confidence: 98%

Section: Clinical Perspective On P 1774mentioning

confidence: 99%

Outcomes After Acute Myocardial Infarction in HIV-Infected Patients

et al. 2013

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“…Both asymptomatic HIV infection and AIDS are consistently associated with a higher risk of coronary artery disease (CAD) [1,2]. The introduction of highly active anti-retroviral therapy (HAART) has resulted in a dramatic improvement in morbidity and mortality of HIV-infected patients [3].…”

Section: Introductionmentioning

confidence: 99%

“…However, the existing data suggest the opposite: despite treatment, or possibly because of it, HIV infection is associated with an increased risk of development of atherosclerosis [4] and at least a 3-fold increase of the risk of CAD [4,5]. Cardiovascular complications are rapidly becoming one of the prevalent causes of morbidity and mortality in HIV-infected patients [2], however, the relative contribution of HIV infection itself and adverse effects of the anti-retroviral treatment is not clear.…”

Section: Introductionmentioning

confidence: 99%

HIV infection and high density lipoprotein metabolism

et al. 2008

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HIV infection and its treatment are associated with dyslipidemia, including hypoalphalipoproteinemia, and increased risk of cardiovascular disease. Parameters of HDL metabolism in HIV-positive patients were investigated in a cross-sectional study. The following groups of subjects were selected: i) 25 treatment-naïve HIV-infected patients or HIV-infected patients on long therapy break, ii) 28 HIV-infected patients currently treated with protease inhibitors, and iii) 33 HIV-negative subjects. Compared to the HIV-negative group, all groups of HIV-infected patients were characterized by significantly elevated triglyceride and apolipoprotein B levels, mass and activity of lecithin cholesterol acyl transferase and cholesteryl ester transfer protein (p<0.01). Total and LDL cholesterol was lower in treatment-naïve HIV-infected group only. HDL cholesterol and preβ 1 -HDL were significantly lower in all HIV-infected groups (p<0.05), while mean levels of apolipoprotein A-I (apoA-I) and ability of plasma to promote cholesterol efflux were similar in all groups. We found a positive correlation between apoA-I and levels of CD4+ cells (r 2 = 0.3, p<0.001). Plasma level of phospholipid transfer protein was reduced in the group on antiretroviral therapy. Taken together these results suggest that HIV infection is associated with modified HDL metabolism re-directing cholesterol to the apoB-containing lipoproteins and likely reducing the functionality of reverse cholesterol transport.

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“…Varriale et al conducted a 3-year prospective study with 690 hospitalized HIV-infected patients 65 . There were 29 cases of myocardial infarction during the study, with an incidence of 1/100 patients-year of observation, similar to what is found in the general North-American population.…”

Section: Epidemiology Of Cardiovascular Events and Risk Factors For Amentioning

confidence: 99%