Carballo David, Delhumeau Cécile, Carballo Sebastian, Bähler Caroline, Radovanovic Dragona, Hirschel Bernard, Clerc Olivier, Bernasconi Enos, Fasel Dominique, Schmid Patrick, Cusini Alexia, Fehr Jan, Erne Paul, Keller Pierre-Fréderic, Ledergerber Bruno, Calmy Alexandra
Department of Cardiology, University Hospital, Geneva, Switzerland.
HIV Metabolic Clinic, University Hospital, Geneva, Switzerland.
AIDS Res Ther. 2015 Feb 22;12:4. doi: 10.1186/s12981-015-0045-z. eCollection 2015.
HIV infection may be associated with an increased recurrence rate of myocardial infarction. Our aim was to determine whether HIV infection is a risk factor for worse outcomes in patients with coronaray artery disease.
We compared data aggregated from two ongoing cohorts: (i) the Acute Myocardial Infarction in Switzerland (AMIS) registry, which includes patients with acute myocardial infarction (AMI), and (ii) the Swiss HIV Cohort Study (SHCS), a prospective registry of HIV-positive (HIV+) patients. We included all patients who survived an incident AMI occurring on or after 1st January 2005. Our primary outcome measure was all-cause mortality at one year; secondary outcomes included AMI recurrence and cardiovascular-related hospitalisations. Comparisons used Cox and logistic regression analyses, respectively.
There were 133 HIV+, (SHCS) and 5,328 HIV-negative [HIV-] (AMIS) individuals with incident AMI. In the SHCS and AMIS registries, patients were predominantly male (72% and 85% male, respectively), with a median age of 51 years (interquartile range [IQR] 46-57) and 64 years (IQR 55-74), respectively. Nearly all (90%) of HIV+ individuals were on successful antiretroviral therapy. During the first year of follow-up, 5 (3.6%) HIV+ and 135 (2.5%) HIV- individuals died. At one year, HIV+ status after adjustment for age, sex, calendar year of AMI, smoking status, hypertension and diabetes was associated with a higher risk of death (HR 4.42, 95% CI 1.73-11.27). There were no significant differences in recurrent AMIs (4 [3.0%] HIV+ and 146 [3.0%] HIV- individuals, OR 1.16, 95% CI 0.41-3.27) or in hospitalization rates (OR 0.68 [95% CI 0.42-1.11]).
HIV infection was associated with a significantly increased risk of all-cause mortality one year after incident AMI.
HIV感染可能与心肌梗死复发率增加有关。我们的目的是确定HIV感染是否是冠状动脉疾病患者预后较差的危险因素。
我们比较了两个正在进行的队列汇总的数据：（i）瑞士急性心肌梗死（AMIS）登记处，其中包括急性心肌梗死（AMI）患者，以及（ii）瑞士HIV队列研究（SHCS），这是一个HIV阳性（HIV+）患者的前瞻性登记处。我们纳入了所有在2005年1月1日或之后发生的首次AMI中存活下来的患者。我们的主要结局指标是一年时的全因死亡率；次要结局包括AMI复发和心血管相关住院。比较分别使用Cox和逻辑回归分析。
有133名HIV+（SHCS）和5328名HIV阴性[HIV-]（AMIS）个体发生首次AMI。在SHCS和AMIS登记处，患者主要为男性（分别为72%和85%为男性），中位年龄分别为51岁（四分位间距[IQR]46 - 57）和64岁（IQR 55 - 74）。几乎所有（90%）的HIV+个体都接受了成功的抗逆转录病毒治疗。在随访的第一年，5名（3.6%）HIV+个体和135名（2.5%）HIV-个体死亡。在调整年龄、性别、AMI的日历年、吸烟状况、高血压和糖尿病后，HIV+状态与更高的死亡风险相关（风险比4.42，95%置信区间1.73 - 11.27）。复发性AMI（4名[3.0%]HIV+个体和146名[3.0%]HIV-个体，比值比1.16，95%置信区间0.41 - 3.27）或住院率（比值比0.68[95%置信区间0.42 - 1.11]）没有显著差异。
HIV感染与首次AMI后一年时全因死亡率显著增加相关。
