Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN.
J Acquir Immune Defic Syndr. 2020 Nov 1;85(3):331-339. doi: 10.1097/QAI.0000000000002442.
There are limited data on the outcomes of acute myocardial infarction-cardiogenic shock (AMI-CS) in patients with HIV infection and AIDS.
Twenty percent sample of all US hospitals.
A retrospective cohort of AMI-CS during 2000-2017 from the National Inpatient Sample was evaluated for concomitant HIV and AIDS. Outcomes of interest included in-hospital mortality and use of cardiac procedures. A subgroup analysis was performed for those with and without AIDS within the HIV cohort.
A total 557,974 AMI-CS admissions were included, with HIV and AIDS in 1321 (0.2%) and 985 (0.2%), respectively. The HIV cohort was younger (54.1 vs. 69.0 years), more often men, of non-White race, uninsured, from a lower socioeconomic status, and with higher comorbidity (all P < 0.001). The HIV cohort had comparable multiorgan failure (37.8% vs. 39.0%) and cardiac arrest (28.7% vs. 27.4%) (P > 0.05). The cohorts with and without HIV had comparable rates of coronary angiography (70.2% vs. 69.0%; P = 0.37) but less frequent early coronary angiography (hospital day zero) (39.1% vs. 42.5%; P < 0.001). The cohort with HIV had higher unadjusted but comparable adjusted in-hospital mortality compared with those without [26.9% vs. 37.4%; adjusted odds ratio 1.04 (95% confidence interval: 0.90 to 1.21); P = 0.61]. In the HIV cohort, AIDS was associated with higher in-hospital mortality [28.8% vs. 21.1%; adjusted odds ratio 4.12 (95% confidence interval: 1.89 to 9.00); P < 0.001].
The cohort with HIV had comparable rates of cardiac procedures and in-hospital mortality; however, those with AIDS had higher in-hospital mortality.
在感染人类免疫缺陷病毒（HIV）和艾滋病（AIDS）的患者中，急性心肌梗死合并心原性休克（AMI-CS）的结局数据有限。
全美 20%的医院样本。
回顾性分析了 2000 年至 2017 年期间国家住院患者样本中 AMI-CS 合并 HIV 和 AIDS 的情况。主要观察指标为院内死亡率和心脏手术的应用。对 HIV 队列中有无 AIDS 的亚组进行了分析。
共纳入 557974 例 AMI-CS 住院患者，其中 HIV 和 AIDS 分别为 1321 例（0.2%）和 985 例（0.2%）。HIV 组年龄较小（54.1 岁比 69.0 岁），男性更多，非白种人，无保险，社会经济地位较低，合并症更多（均 P < 0.001）。HIV 组多器官衰竭（37.8%比 39.0%）和心脏骤停（28.7%比 27.4%）发生率相近（均 P > 0.05）。有和无 HIV 的两组接受冠状动脉造影的比例相近（70.2%比 69.0%；P = 0.37），但早期冠状动脉造影（入院当天）的比例较低（39.1%比 42.5%；P < 0.001）。未经校正的 HIV 组住院死亡率较高，但校正后两组无差异[26.9%比 37.4%；校正比值比 1.04（95%置信区间：0.90 至 1.21）；P = 0.61]。在 HIV 组中，AIDS 与更高的住院死亡率相关[28.8%比 21.1%；校正比值比 4.12（95%置信区间：1.89 至 9.00）；P < 0.001]。
HIV 组的心脏手术和院内死亡率相近；然而，患有 AIDS 的患者的住院死亡率更高。
