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Abstract
Protease inhibitor drug use and adverse cardiovascular events in ambulatory HIV-infected patients
S D Holmberg1, A C Moorman1, T C Tong1, D J Ward2, K C Wood3, A E Greenberg1, R S Janssen1
1CDC, Atlanta, GA, United States; 2Dupont Circle Physicians Group, Washington, DC, United States; 3Cerner Corp., Vienna, VA, United States
Background-- Protease inhibitor drugs (PIs) for HIV have been linked to hyperlipidemia, insulin resistance and other risk factors for cardiovascular disease.
Methods-- To determine if the rate of myocardial infarction (MI), angina, or cerebrovascular accident (CVA) is increased in HIV-infected patients taking PIs, we analyzed a dynamic cohort. This analysis included prosepctively collected data from 5,676 ambulatory HIV-infected patients seen between January 1993 and January 2001 at 9 (7 private, 2 public) HIV clinics in 8 U.S. cities. .
Results.-- MIs in this cohort significantly increased by year after the introduction of PI drugs in 1996 (linear test for trend, p= 0.0124). Thirteen of 3,013 patients taking PI drugs but only two of 2,663 patients who did not take these drugs had an MI (unadjusted odds ratio [ORunadj] = 5.77; 95 percent confidence intervals [95% CIs] 1.3, 25.6; p= 0.009). This strong association remained in multivariate models controlling for hypertension, smoking, diabetes, age, gender, and evidence of dyslipidemia (adjusted OR [ORadj]= 4.92; 95% CIs 1.3, 32.3; p= 0.04). Angina and CVAs, were not significantly increased in those taking compared to those not taking PI drugs (ORunadj, 3.10; 95% CI, 0.64-14.94; p= 0.187; and ORunadj 0.38; 95% CI, 0.10-1.47; p= 0.206, respectively).
Conclusions.-- Although MIs occurred infrequently and usually in persons with other cardiovascular risk factors, protease inhibitor drug use was temporally and statistically associated with the incidence of MIs in these ambulatory HIV-infected patients
The XIV International AIDS Conference
Abstract no.
TuPeB4494
Suggested Citation
" S D Holmberg , , et al.
Protease inhibitor drug use and adverse cardiovascular events in ambulatory HIV-infected patients
.
Poster Exhibition:
The XIV International AIDS Conference:
Abstract no.
TuPeB4494"
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