Rural-Urban Trends in Congenital Heart Disease-Related Mortality in the United States, 1999 to 2019

Minhas, Abdul Mannan Khan; Wyand, Rachel A.; Ariss, Robert W.; Nazir, Salik; Jain, Vardhmaan; Al‐Kindi, Sadeer G.; Shapiro, Michael D.; Campbell, W. W.; Sperling, Laurence; Virani, Salim S.

doi:10.1016/j.jacadv.2022.100030

Cited by 2 publications

(2 citation statements)

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Section: Discussionmentioning

confidence: 99%

“…Our findings that HIV is associated with higher risk of substance-related death are confirmed in the autopsy subset and are likely attributable to higher rates of substance use among PWH (17) as the association was attenuated accounting for documented substance use. Rising rates of substance-associated cardiovascular death across the United States suggest that this growing problem extends to the general population without HIV (18). Durstenfeld et al HIV & HF Phenotypes and Outcomes in a Safety Net System One potential explanation for lower rates of HF hospitalization specific to the study population may be that PWH may be better connected to ambulatory care within the municipal health system in San Francisco compared to people without HIV, as demonstrated by the higher rates of ambulatory follow-up after HF hospitalization.…”

Section: Similar Associations With Mortality As Compared To Prior Stu...mentioning

confidence: 99%

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HIV-Associated Heart Failure: Phenotypes and Clinical Outcomes in a Safety-Net Setting

Durstenfeld,

Thakkar,

Jeon

et al. 2024

Preprint

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Background: Human immunodeficiency virus (HIV) is associated with increased risk of heart failure (HF) but data regarding phenotypes of heart failure and outcomes after HF diagnosis, especially within the safety-net which is where half of people with HIV in the United States receive care, are less clear. Methods: Using an electronic health record cohort of all individuals with HF within a municipal safety-net system from 2001-2019 linked to the National Death Index Plus, we compared HF phenotypes, all-cause mortality, HF hospitalization, and cause of death for individuals with and without HIV. Results: Among people with HF (n=14,829), 697 individuals had HIV (4.7%). Persons with HIV (PWH) were diagnosed with HF ten years younger on average. A higher proportion of PWH had a reduced ejection fraction at diagnosis (37.9% vs 32.7%). Adjusted for age, sex, and risk factors, coronary artery disease on angiography was similar by HIV status. HIV was associated with 55% higher risk of all-cause mortality (HR 1.55; 95% CI 1.37-1.76; P<0.001) and lower odds of HF hospitalization (OR 0.51; 95% CI 0.39-0.66; P<0.001). Among PWH with HF, cause of death was less often attributed to cardiovascular disease (22.5% vs 54.6% uninfected; P<0.001) and more to substance use (17.9% vs 9.3%; P<0.001), consistent with autopsy findings in a subset (n=81). Conclusions: Among people with HF who receive care within a municipal safety-net system, HIV infection is associated with higher mortality, despite lower odds of HF hospitalization, attributable to non-cardiovascular causes including substance-related and HIV-related mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Similar Associations With Mortality As Compared To Prior Stu...mentioning

confidence: 99%