Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease
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CONTEXT: Metabolic changes and smoking are common among HIV patients and may confer increased cardiovascular risk. OBJECTIVE: The aim of the study was to determine acute myocardial infarction (AMI) rates and cardiovascular risk factors in HIV compared with non-HIV patients in two tertiary care hospitals. DESIGN, SETTING, AND PARTICIPANTS: We conducted a health care system-based cohort study using a large data registry with 3,851 HIV and 1,044,589 non-HIV patients. AMI rates were determined among patients receiving longitudinal care between October 1, 1996, and June 30, 2004. MAIN OUTCOME MEASURES: The primary outcome was myocardial infarction, identified by International Classification of Diseases coding criteria. RESULTS: AMI was identified in 189 HIV and 26,142 non-HIV patients. AMI rates per 1000 person-years were increased in HIV vs. non-HIV patients [11.13 (95% confidence interval [CI] 9.58-12.68) vs. 6.98 (95% CI 6.89-7.06)]. The HIV cohort had significantly higher proportions of hypertension (21.2 vs. 15.9%), diabetes (11.5 vs. 6.6%), and dyslipidemia (23.3 vs. 17.6%) than the non-HIV cohort (P < 0.0001 for each comparison). The difference in AMI rates between HIV and non-HIV patients was significant, with a relative risk (RR) of 1.75 (95% CI 1.51-2.02; P < 0.0001), adjusting for age, gender, race, hypertension, diabetes, and dyslipidemia. In gender-stratified models, the unadjusted AMI rates per 1000 person-years were higher for HIV patients among women (12.71 vs. 4.88 for HIV compared with non-HIV women), but not among men (10.48 vs. 11.44 for HIV compared with non-HIV men). The RRs (for HIV vs. non-HIV) were 2.98 (95% CI 2.33-3.75; P < 0.0001) for women and 1.40 (95% CI 1.16-1.67; P = 0.0003) for men, adjusting for age, gender, race, hypertension, diabetes, and dyslipidemia. A limitation of this database is that it contains incomplete data on smoking. Smoking could not be included in the overall regression model, and some of the increased risk may be accounted for by differences in smoking rates. CONCLUSIONS: AMI rates and cardiovascular risk factors were increased in HIV compared with non-HIV patients, particularly among women. Cardiac risk modification strategies are important for the long-term care of HIV patients.
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Cardiovascular risk remains high even after adjusting for traditional risk factors.
“CVD risk remains high even after adjusting for traditional risk factors.434”
From 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias (2016) · cites this paper as [434]
Antiretroviral therapy is associated with an increased prevalence of type 2 diabetes mellitus and insulin resistance among HIV-infected patients.
“Antiretroviral therapy has been associated with an increased prevalence of type 2 diabetes mellitus and insulin resistance among HIV-infected patients [114].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [114]
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- Authors
- Triant, V. A., Lee, H., Hadigan, C., & Grinspoon, S. K.
- Affiliations
- Brigham and Women's Hospital (US)
- Harvard University (US)
- Corresponding author
- Grinspoon, Steven K.
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2007-07-01
- Volume
- 92
- Issue
- 7
- Pages
- 2506-2512
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- PMC
- PMC2763385
- OpenAlex
- W2148314152
- Cited by
- 1,613
- References
- 26
- Citations by year
- 2026: 35 · 2025: 44 · 2024: 64 · 2023: 62 · 2022: 83 · 2021: 99 · 2020: 85 · 2019: 90 · 2018: 102 · 2017: 125 · 2016: 124 · 2015: 121 · 2014: 126 · 2013: 109 · 2012: 81
- FWCI
- 60.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (K01AI073109, T32AI007387)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK 49302, R01DK059535, DK 59535, R01DK049302)
- National Center for Research Resources (RR 01066, M01RR001066)
- Topics
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- acute myocardial infarction, HIV infection, cardiovascular risk factors, hypertension, diabetes mellitus, dyslipidemia, smoking, metabolic changes, sex differences, cardiovascular disease in HIV, women living with HIV, HIV-positive men, cardiovascular risk stratification, cardiovascular risk counseling
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Longitudinal Studies, Male, Middle Aged, Myocardial Infarction, Risk Factors, Sensitivity and Specificity, Smoking, Reproducibility of Results, HIV Infections, Age Distribution
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