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Increased mortality after a first myocardial infarction in human immunodeficiency virus-infected patients; a nested cohort study.

Type of publication Peer-reviewed
Publikationsform Original article (peer-reviewed)
Author 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,
Project Swiss HIV Cohort Study (SHCS)
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Original article (peer-reviewed)

Journal AIDS research and therapy
Volume (Issue) 12
Page(s) 4 - 4
Title of proceedings AIDS research and therapy
DOI 10.1186/s12981-015-0045-z

Open Access

URL http://doi.org/10.1186/s12981-015-0045-z
Type of Open Access Publisher (Gold Open Access)

Abstract

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.
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