Association of Immunologic and Virologic Factors with Myocardial Infarction Rates in a US Healthcare System

Overview

Journal J Acquir Immune Defic Syndr

Specialty Infectious Diseases

Date 2010 Sep 10

PMID 20827215

Citations 94

Authors

Virginia A Triant

Susan Regan

Hang Lee

Paul E Sax

James B Meigs

Steven K Grinspoon

Affiliations

Soon will be listed here.

Abstract

Background: The effects of immunologic and virologic factors on acute myocardial infarction (AMI) rates in patients with HIV are unclear.

Methods: HIV-infected patients in a US healthcare system were assessed for AMI.

Results: Of 6517 patients with HIV, 273 (4.2%) had an AMI. In a model adjusting for cardiovascular risk factors, antiretroviral medications, and HIV parameters, CD4 count less than 200/mm (odds ratio, 1.74; 95% confidence interval, 1.07 to 2.81; P = 0.02) predicted AMI. Increased HIV viral load was associated with AMI accounting for cardiovascular disease risk factors and antiretroviral medications but was not significant when CD4 count was considered.

Conclusions: Immunologic control appears to be the most important HIV-related factor associated with AMI.

Citing Articles

Viremia Does Not Independently Predict Cardiovascular Disease in People With HIV: A RESPOND Cohort Study.

Elvstam O, Ryom L, Neesgaard B, Tau L, Gunthard H, Zangerle R Open Forum Infect Dis. 2025; 12(2):ofaf016.

PMID: 39896984 PMC: 11786055. DOI: 10.1093/ofid/ofaf016.

Cardiovascular Risk Estimation Is Suboptimal in People With HIV.

Triant V, Lyass A, Hurley L, Borowsky L, Ehrbar R, He W J Am Heart Assoc. 2024; 13(10):e029228.

PMID: 38761071 PMC: 11179796. DOI: 10.1161/JAHA.123.029228.

The dynamic risk factors of cardiovascular disease among people living with HIV: a real-world data study.

Liu Z, Zhang J, Yang X, Gao H, Chen S, Weissman S BMC Public Health. 2024; 24(1):1162.

PMID: 38664682 PMC: 11044498. DOI: 10.1186/s12889-024-18672-x.

Evolving mechanisms and presentations of cardiovascular disease in people with HIV: implications for management.

Nazari I, Feinstein M Clin Microbiol Rev. 2024; 37(1):e0009822.

PMID: 38299802 PMC: 10938901. DOI: 10.1128/cmr.00098-22.

Cardiovascular Disease Risk Factor Control in People With and Without HIV.

Silverberg M, Levine T, Lea A, Williams A, Alexeeff S, Bryant K Clin Infect Dis. 2024; 78(5):1264-1271.

PMID: 38227614 PMC: 11093675. DOI: 10.1093/cid/ciad728.

References

Friis-Moller N, Reiss P, Sabin C, Weber R, Monforte A, El-Sadr W . Class of antiretroviral drugs and the risk of myocardial infarction. N Engl J Med. 2007; 356(17):1723-35. DOI: 10.1056/NEJMoa062744. View

Triant V, Meigs J, Grinspoon S . Association of C-reactive protein and HIV infection with acute myocardial infarction. J Acquir Immune Defic Syndr. 2009; 51(3):268-73. PMC: 2763381. DOI: 10.1097/QAI.0b013e3181a9992c. View

Currier J, Taylor A, Boyd F, Dezii C, Kawabata H, Burtcel B . Coronary heart disease in HIV-infected individuals. J Acquir Immune Defic Syndr. 2003; 33(4):506-12. DOI: 10.1097/00126334-200308010-00012. View

Baker J, Peng G, Rapkin J, Abrams D, Silverberg M, MacArthur R . CD4+ count and risk of non-AIDS diseases following initial treatment for HIV infection. AIDS. 2008; 22(7):841-8. PMC: 3618460. DOI: 10.1097/QAD.0b013e3282f7cb76. View

Phillips A, Carr A, Neuhaus J, Visnegarwala F, Prineas R, Burman W . Interruption of antiretroviral therapy and risk of cardiovascular disease in persons with HIV-1 infection: exploratory analyses from the SMART trial. Antivir Ther. 2008; 13(2):177-87. DOI: 10.1177/135965350801300215. View

Kaplan R, Kingsley L, Gange S, Benning L, Jacobson L, Lazar J . Low CD4+ T-cell count as a major atherosclerosis risk factor in HIV-infected women and men. AIDS. 2008; 22(13):1615-24. PMC: 2624572. DOI: 10.1097/QAD.0b013e328300581d. View

George E, Lucas G, Nadkarni G, Fine D, Moore R, Atta M . Kidney function and the risk of cardiovascular events in HIV-1-infected patients. AIDS. 2009; 24(3):387-94. PMC: 2877370. DOI: 10.1097/QAD.0b013e3283359253. View

Triant V, Lee H, Hadigan C, Grinspoon S . Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab. 2007; 92(7):2506-12. PMC: 2763385. DOI: 10.1210/jc.2006-2190. View

Zeng Q, Goryachev S, Weiss S, Sordo M, Murphy S, Lazarus R . Extracting principal diagnosis, co-morbidity and smoking status for asthma research: evaluation of a natural language processing system. BMC Med Inform Decis Mak. 2006; 6:30. PMC: 1553439. DOI: 10.1186/1472-6947-6-30. View

10.

Worm S, Sabin C, Weber R, Reiss P, El-Sadr W, Dabis F . Risk of myocardial infarction in patients with HIV infection exposed to specific individual antiretroviral drugs from the 3 major drug classes: the data collection on adverse events of anti-HIV drugs (D:A:D) study. J Infect Dis. 2009; 201(3):318-30. DOI: 10.1086/649897. View

11.

Marin B, Thiebaut R, Bucher H, Rondeau V, Costagliola D, Dorrucci M . Non-AIDS-defining deaths and immunodeficiency in the era of combination antiretroviral therapy. AIDS. 2009; 23(13):1743-53. PMC: 3305466. DOI: 10.1097/QAD.0b013e32832e9b78. View

12.

Bonnet F, Chene G, Thiebaut R, Dupon M, Lawson-Ayayi S, Pellegrin J . Trends and determinants of severe morbidity in HIV-infected patients: the ANRS CO3 Aquitaine Cohort, 2000-2004. HIV Med. 2007; 8(8):547-54. DOI: 10.1111/j.1468-1293.2007.00508.x. View

13.

Ford E, Greenwald J, Richterman A, Rupert A, Dutcher L, Badralmaa Y . Traditional risk factors and D-dimer predict incident cardiovascular disease events in chronic HIV infection. AIDS. 2010; 24(10):1509-17. PMC: 2884071. DOI: 10.1097/QAD.0b013e32833ad914. View

14.

. Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients. AIDS. 2008; 22(14):F17-24. PMC: 2644883. DOI: 10.1097/QAD.0b013e32830fe35e. View