Author + information
- Xiaoming Jia,
- David Wong,
- Ihab Hamzeh,
- Salim Virani,
- Nasser Lakkis and
- Mahboob Alam
Background: Human immune deficiency virus (HIV) infection is thought to confer increased risk of coronary artery disease and acute coronary syndrome, with an increasing number of HIV+ patients requiring revascularization. Current data on outcomes of HIV+ patients after coronary revascularization have yielded mixed conclusions and are limited by modest sample sizes.
Methods: A systematic review was performed, screening for studies on percutaneous coronary intervention and coronary artery bypass grafting outcomes in HIV+ and HIV- patients. Baseline characteristics and outcomes data were appraised and pooled. Random effect model computing odds ratios (OR) with 95% confidence intervals (CI) was used to estimate effect size for major adverse cardiac events (MACE), in-hospital mortality, overall mortality and target vessel revascularization (TVR).
Results: Seven studies encompassing 955 patients were identified. Baseline characteristics were mostly similar between the two groups except for younger age and less diabetes in the HIV+ compared to the HIV- group, (52.4 vs 55.1, p=0.0015) and (21.8% vs 29.9%, p = 0.0301), respectively. Meta-analysis showed statistically significant increase of MACE in HIV+ patients compared with HIV- patients (OR 1.47, CI 1.04-2.07), which appears to be driven by poorer outcomes after bypass surgery. There was no significant difference in MACE between the two groups when percutaneous coronary intervention was analyzed alone (OR 1.34, CI 0.93-1.94). Moreover, there was no statistically significant difference between HIV+ and HIV- patients in overall mortality (OR 1.63, CI 0.81-3.26), in-hospital mortality (OR 1.15, CI 0.43-3.06) or TVR (OR 1.23, CI 0.80-1.91).
Conclusions: No significant mortality difference was observed between HIV+ and HIV- patients. HIV infection was associated with increased cardiovascular events after coronary revascularization, which was primarily driven by worse outcomes seen after bypass surgery. However, the number of studies in this group was limited.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: PCI in Complex Patients
Abstract Category: 19. Interventional Cardiology: Complex Patients/Comorbidities
Presentation Number: 1287-193
- 2017 American College of Cardiology Foundation