Outcomes After Acute Myocardial Infarction in HIV-Infected Patients

Abstract

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.

Haemoptysis in adults: a 5-year study using the French nationwide hospital administrative database

“…However, as the frequency of haemoptysis found in our study correlates with previous studies, we feel that such inaccuracies may not be considerable. Indeed, recent studies that investigated the reliability of PMSI data by comparing them with reference data from other sources, including a stroke registry, a perinatal survey and vaccine safety assessments, showed that PMSI data can be reliably used for epidemiological purposes [10][11][12][13].…”

“…The French national administrative database, also called the medicalisation of information system programme (PMSI) provides a huge amount of epidemiological information concerning hospitalised French patients [10][11][12][13][14][15][16]. Data pertaining to haemoptysis are reliable enough to count such patients and to describe the aetiologies of the condition.…”

Patients With Ischemic Stroke and Incident Atrial Fibrillation

“…The reliability of PMSI data has already been assessed, 17,18 and PMSI has previously been used to study patients with stroke, myocardial infarction, and AF. [19][20][21] The study population comprised adults with a diagnosis of acute ischemic stroke (I63 and its subsections using International Classification of Diseases, Tenth Revision codes) coded in the principal diagnosis (ie, the health problem that justified admission to hospital), the related diagnosis (ie, potential chronic disease or health state during hospital stay), or the significantly associated diagnosis (ie, comorbidity or associated complication) who were hospitalized from January 1 to December 31, 2009. Of note, asymptomatic cerebrovascular diseases and sequelae of stroke have different codes (I65-I66 and I69 with subdivisions) to be distinguished from acute strokes in the patients of our analysis.…”

HIV and coronary disease – When secondary prevention is insufficient

“…Hsue et al 32 reported a higher restenosis rate after PCI in HIV-infected patients than in controls (52% vs. 14%, p=0.006), but other studies 10,11 have reported similar rates of cardiovascular adverse events in patients with and without HIV infection undergoing PCI with drug-eluting stents in the context of ACS.…”