Author + information
- Hany Abdallah,
- Farid Gholitabar,
- Erna Kojic and
- Vani Gandhi
Background: Since the advent of HAART (Highly Active Anti-Retroviral Therapy), HIV patients have reduced incidence of opportunistic infections and longer life expectancy. HIV patients have demonstrated increased risk of developing CHD/AMI (Acute Myocardial Infarction) compared to those without HIV infection. The goal of this study was to expose how the natural history of CHD may impact those with HIV infection at a significantly earlier age.
Methods: This was a retrospective cohort study using the 2013 National Inpatient Sample, the largest publically available inpatient database in the United States. The inclusion criteria were age older than 18 years and an ICD-9 CM code for any diagnosis of HIV without HIV-related disease (V08). The primary outcome was age at first PCI (Percutaneous Coronary Intervention). Odds ratios and means were adjusted for the following confounders using multivariate regression analysis models: sex, Diabetes Mellitus Type 2 (DM), DM with complications, Hyperlipidemia (HLD), Hypertension (HTN), smoking, and obesity.
Results: 500,600 patients who underwent a PCI were included in the study, 1150 (0.23%) of whom had HIV. The mean age of those with HIV and PCI was 55.1 years and 180 (15.7%) were female. 64.6 was the mean age of those who underwent PCI without HIV. The unadjusted age difference between those with and without HIV was 9.5 years (p=0.000 – linear regression). When adjusted for comorbidities difference was 9.0 years (p=0.000 – linear regression).
Conclusions: Patients with HIV are on average nine years younger during their first PCI compared to those without HIV when adjusted for comorbidities. There is evidence that the HIV virus increases the risk of CHD independent of other risk factors. HIV is a significant independent risk factor for the development of CHD. This is substantial evidence to support more vigilant risk factor modification in those with HIV and more stringent (earlier and more specific) CHD screening methods for those with HIV.
Moderated Poster Contributions
Acute and Stable Ischemic Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 10:30 a.m.-10:40 a.m.
Session Title: Post-CAD/MI: Making Tough Predictions About the Future
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1138M-07
- 2017 American College of Cardiology Foundation