Centre for Clinical Research, Epidemiology, Modelling and Evaluation, Institute for Global Health, Royal Free Campus, University College London, London, UK.
CHIP, Department of Infectious Diseases Section 2100, Finsencentret, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
AIDS. 2018 Jan 2;32(1):79-88. doi: 10.1097/QAD.0000000000001666.
To investigate the association between abacavir (ABC) use and recurrent myocardial infarction (MI) among HIV-positive people with a prior MI.
International multicohort collaboration with follow-up from 1999 to 2016.
The rate of recurrent MI was described among D:A:D participants who experienced an index MI whilst in the study, and who remained under follow-up beyond 28 days after this MI. Follow-up was considered to the date of next MI, death, 1 February 2016 or 6 months after last clinic visit. Poisson regression models considered associations between recurrent MI and exposure to ABC (use at index MI, current post-MI exposure and cumulative exposure), before and after adjusting for calendar year.
The 984 individuals who experienced an index MI during the study (91.3% male, median age 51 at index MI) were followed for 5312 person-years, over which time there were 136 recurrent MIs (rate 2.56/100 person-years, 95% confidence interval 2.13-2.99). Rates were 2.40 (1.71-3.09) and 2.65 (2.10-3.21)/100 person-years in those who were and were not on ABC, respectively, at the index MI, and 2.90 (2.01-3.78) and 2.44 (1.95-2.93)/100 person-years in those who were and were not currently receiving ABC, respectively, post-MI. No association was seen with recurrent MI and either cumulative exposure to ABC [relative rate 0.86 (0.68-1.10)/5 years], receipt of ABC at index MI [0.90 (0.63-1.29)] nor recent post-MI exposure to ABC [1.19 (0.82-1.71)].
Among people with a previous MI, there was no evidence for an association between use of ABC post-MI and an elevated risk of a recurrent MI.
研究在发生过心肌梗死（MI）的 HIV 阳性人群中，使用阿巴卡韦（ABC）与复发性 MI 之间的关联。
国际多队列合作，随访时间为 1999 年至 2016 年。
在 D:A:D 参与者中描述了发生指数 MI 时的复发性 MI 发生率，并且在 MI 后超过 28 天仍在随访中。随访时间截止到下一次 MI、死亡、2016 年 2 月 1 日或最后一次就诊后 6 个月。泊松回归模型考虑了复发性 MI 与 ABC 暴露（在指数 MI 时使用、MI 后当前暴露和累积暴露）之间的关联，在调整了日历年后进行了考虑。
在研究期间发生指数 MI 的 984 名个体（91.3%为男性，指数 MI 时的中位年龄为 51 岁）随访了 5312 人年，在此期间发生了 136 例复发性 MI（发生率为 2.56/100 人年，95%置信区间为 2.13-2.99）。在指数 MI 时分别使用和不使用 ABC 的个体的发生率分别为 2.40（1.71-3.09）和 2.65（2.10-3.21）/100 人年，在 MI 后分别接受和不接受 ABC 的个体的发生率分别为 2.90（2.01-3.78）和 2.44（1.95-2.93）/100 人年。与复发性 MI 无关联的因素包括 ABC 的累积暴露[相对风险 0.86（0.68-1.10）/5 年]、在指数 MI 时使用 ABC[0.90（0.63-1.29）]或 MI 后近期使用 ABC[1.19（0.82-1.71）]。
在有既往 MI 的人群中，MI 后使用 ABC 与复发性 MI 风险升高之间没有证据表明存在关联。
