Lower likelihood of cardiac procedures after acute coronary syndrome in patients with human immunodeficiency virus/acquired immunodeficiency syndrome.

Clement, Meredith E

Lin, Li

Navar, Ann Marie

Okeke, Nwora Lance

Naggie, Susanna

Douglas, Pamela S

2023-03-02T15:13:00Z

2023-03-02T15:13:00Z

2018-02

2023-03-02T15:12:59Z

Cardiovascular disease (CVD) is an increasing cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected adults; however, this population may be less likely to receive interventions during hospitalization for acute coronary syndrome (ACS). The degree to which this disparity can be attributed to poorly controlled HIV infection is unknown.In this large cohort study, we used the National Inpatient Sample (NIS) to compare rates of cardiac procedures among patients with asymptomatic HIV-infection, symptomatic acquired immunodeficiency syndrome (AIDS), and uninfected adults hospitalized with ACS from 2009 to 2012. Multivariable analysis was used to compare procedure rates by HIV status, with appropriate weighting to account for NIS sampling design including stratification and hospital clustering.The dataset included 1,091,759 ACS hospitalizations, 0.35% of which (n = 3783) were in HIV-infected patients. Patients with symptomatic AIDS, asymptomatic HIV, and uninfected patients differed by sex, race, and income status. Overall rates of cardiac catheterization and revascularization were 53.3% and 37.4%, respectively. In multivariable regression, we found that relative to uninfected patients, those with symptomatic AIDS were less likely to undergo catheterization (odds ratio [OR] 0.48, confidence interval [CI] 0.43-0.55), percutaneous coronary intervention (OR 0.69, CI 0.59-0.79), and coronary artery bypass grafting (0.75, CI 0.61-0.93). No difference was seen for those with asymptomatic HIV relative to uninfected patients (OR 0.93, CI 0.81-1.07; OR 1.06, CI 0.93-1.21; OR 0.88, CI 0.72-1.06, respectively).We found that lower rates of cardiovascular procedures in HIV-infected patients were primarily driven by less frequent procedures in those with AIDS.

00005792-201802090-00037

0304-5412

1536-5964

https://hdl.handle.net/10161/26709

eng

Ovid Technologies (Wolters Kluwer Health)

Medicine

10.1097/md.0000000000009849

Humans

HIV Infections

Acquired Immunodeficiency Syndrome

Hospitalization

Coronary Artery Bypass

Likelihood Functions

Cohort Studies

Patient Selection

Aged

Middle Aged

United States

Female

Male

Acute Coronary Syndrome

Asymptomatic Infections

Cardiac Catheterization

Percutaneous Coronary Intervention

Lower likelihood of cardiac procedures after acute coronary syndrome in patients with human immunodeficiency virus/acquired immunodeficiency syndrome.

Journal article

Naggie, Susanna|0000-0001-7721-6975

Douglas, Pamela S|0000-0001-9876-4049

e9849

6

Duke

School of Medicine

Faculty

Basic Science Departments

Clinical Science Departments

Institutes and Centers

Medicine

Medicine, Cardiology

Medicine, Infectious Diseases

Duke Clinical Research Institute

Population Health Sciences

Published

97