|
|
Abstract
Myocardial infarction rates among HIV-infected patients in a U.S. health care system
V. Triant1, H. Lee2, C. Hadigan2, S. Grinspoon2
Background: Cardiac risk factors are increasingly recognized in individuals with HIV, but limited information is available concerning rates of acute myocardial infarction (AMI) in HIV-infected patients.
Methods: We conducted a cohort study of 4,001 HIV and 1,319,001 non-HIV patients ages 18 to 84 years who presented to Brigham and Women’s or Massachusetts General Hospitals between October 1, 1996 and June 30, 2004. The primary outcome was AMI, identified by ICD coding and cardiac enzyme criteria in separate analyses. HIV status was determined by ICD coding. Odds ratios for AMI were obtained using multivariate logistic regression modeling.
Results: AMI rates were 5.37 (95% CI 4.67-6.07) versus 3.05 (95% CI 3.02-3.08) per 100 persons in the HIV and non-HIV groups, respectively. The unadjusted odds ratio for AMI was 1.81 (95% CI 1.57-2.07; P<0.0001). In a fully adjusted model controlling for age, gender, race, hypertension, diabetes and dyslipidemia, HIV was a significant independent risk factor for AMI (OR 1.77 [95% CI 1.52-2.05; P<0.0001]). The difference in AMI rates between HIV and non-HIV patients was more pronounced among women, with adjusted odds ratios for AMI of 3.70 (95% CI 2.83-4.84; P<0.0001) for women versus 1.43 (95% CI 1.19-1.71; P<0.0001) for men. Analyses using cardiac enzyme criteria demonstrated similar results (adjusted OR 2.17 [95% CI 1.89-2.48; P<0.0001]).
[Myocardial Infarction Rates by Gender]
Conclusions: AMI rates are increased among HIV-infected patients, and HIV is a significant independent risk factor for AMI. Differences in AMI rates are more pronounced among women. As antiretroviral treatment programs continue to expand and more patients are living with HIV globally, monitoring and treating long-term complications such as cardiovascular disease will be important components of HIV care.
AIDS 2006 - XVI International AIDS Conference
Abstract no.
WEPE0179
Suggested Citation
"V.Triant, et al.
Myocardial infarction rates among HIV-infected patients in a U.S. health care system.
:
AIDS 2006 - XVI International AIDS Conference:
Abstract no.
WEPE0179"
|
|
|