Author + information
- Alexandra Steverson,
- Anna E. Pawlowski,
- Daniel Schneider,
- Prasanth Nannapaneni,
- Jes Sanders,
- Chad J. Achenbach,
- Sanjiv Shah,
- Donald Lloyd-Jones and
- Matthew Feinstein
Background: HIV+ persons appear to have elevated risks for HF. However, few studies have evaluated clinical characteristics of HF in HIV and none has adjudicated HF diagnoses. Thus, the extent to which traditional and HIV-specific risk factors contribute to HF in HIV remains unclear. We hypothesized that lower nadir CD4 T cell count (CD4 count) and higher peak HIV viral load (VL) are associated with greater HF risk.
Methods: We adjudicated HF diagnoses in a cohort of 5,052 HIV+ patients (pts) receiving care at an academic center. We compared characteristics of pts with vs. without HF. We used multivariable logistic regression to compare HF risk across levels of nadir CD4 count and peak VL.
Results: HIV+ pts with HF were older and more likely to be black, hypertensive, and diabetic than those without HF. Compared with HIV+ pts with nadir CD4 count ≥500 cells/mm3, those with <200 cells/mm3 were significantly more likely to have HF in unadjusted analyses (OR 2.99, 95% CI 1.80-5.00); this association was attenuated after adjustment for demographics and baseline risk factors (OR 1.59, 0.88 – 2.87). Pts with peak VL ≥100,000 copies/mL were significantly more likely to have HF than pts with <1,000 copies/mL, even after adjustment (OR 1.87, 1.22-2.86; Table 1). There was no significant difference in the proportion of HF patients with reduced EF (<50%) or ischemic etiology of HF across strata of nadir CD4 or peak VL.
Conclusions: Poor HIV viral control and immunosuppression are associated with greater risk for adjudicated HF in HIV.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Making Progress in Understanding Heart Failure
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1123-284
- 2017 American College of Cardiology Foundation