Header

UZH-Logo

Maintenance Infos

Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals


Hatleberg, Camilla Ingrid; Ryom, Lene; El-Sadr, Wafaa; Smith, Colette; Weber, Rainer; Reiss, Peter; Fontas, Eric; Dabis, Francois; Law, Matthew; Monforte, Antonella d'Arminio; De Wit, Stephane; Mocroft, Amanda; Phillips, Andrew; Lundgren, Jens D; Sabin, Caroline (2016). Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals. AIDS, 30(10):1583-1596.

Abstract

OBJECTIVE Few studies have described mortality and clinical outcomes after myocardial infarction (MI) in the HIV-positive population. This study evaluated changes in short-term mortality after MI in HIV-positive individuals in the D:A:D Study, and investigated possible reasons for any changes seen. DESIGN Prospective cohort study. METHODS Demographic, cardiovascular disease (CVD)/HIV-related characteristics and CVD-related interventions (invasive cardiovascular procedures and drug interventions) were summarized at the time of and following an MI. Associations between calendar year and mortality in the first month after MI were identified using logistic regression with adjustment for confounders, including interventions received in the first month after MI. RESULTS One thousand and eight HIV-positive individuals experiencing an MI over the period 1999-2014 were included. The absolute number of MIs decreased from 214 (1999-2002) to 154 (2011-2014). Whilst the CVD risk profile remained high over time, the HIV status improved. The use of CVD-related interventions after MI appeared to increase over time. The proportion of individuals who died in the first month after MI dropped from 26.6% in 1999-2002 to 8.4% in 2011-2014. Later calendar year was associated with decreased short-term mortality; this effect was attenuated after adjusting for CVD-related interventions received in the first month after MI [odds ratio changed from 0.88 (95% confidence interval 0.83, 0.93) to 0.97 (0.91, 1.02)]. CONCLUSION Improvements in short-term survival after MI appear to be largely driven by improved medical management of CVD risk in HIV-positive individuals after MI. Efforts are still needed to treat CVD risk factors and increase access to CVD-related interventions.

Abstract

OBJECTIVE Few studies have described mortality and clinical outcomes after myocardial infarction (MI) in the HIV-positive population. This study evaluated changes in short-term mortality after MI in HIV-positive individuals in the D:A:D Study, and investigated possible reasons for any changes seen. DESIGN Prospective cohort study. METHODS Demographic, cardiovascular disease (CVD)/HIV-related characteristics and CVD-related interventions (invasive cardiovascular procedures and drug interventions) were summarized at the time of and following an MI. Associations between calendar year and mortality in the first month after MI were identified using logistic regression with adjustment for confounders, including interventions received in the first month after MI. RESULTS One thousand and eight HIV-positive individuals experiencing an MI over the period 1999-2014 were included. The absolute number of MIs decreased from 214 (1999-2002) to 154 (2011-2014). Whilst the CVD risk profile remained high over time, the HIV status improved. The use of CVD-related interventions after MI appeared to increase over time. The proportion of individuals who died in the first month after MI dropped from 26.6% in 1999-2002 to 8.4% in 2011-2014. Later calendar year was associated with decreased short-term mortality; this effect was attenuated after adjusting for CVD-related interventions received in the first month after MI [odds ratio changed from 0.88 (95% confidence interval 0.83, 0.93) to 0.97 (0.91, 1.02)]. CONCLUSION Improvements in short-term survival after MI appear to be largely driven by improved medical management of CVD risk in HIV-positive individuals after MI. Efforts are still needed to treat CVD risk factors and increase access to CVD-related interventions.

Statistics

Citations

5 citations in Web of Science®
5 citations in Scopus®
Google Scholar™

Altmetrics

Downloads

39 downloads since deposited on 04 Aug 2016
39 downloads since 12 months
Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:19 June 2016
Deposited On:04 Aug 2016 09:29
Last Modified:08 Dec 2017 20:03
Publisher:Lippincott Williams & Wilkins
ISSN:0269-9370
Publisher DOI:https://doi.org/10.1097/QAD.0000000000001076
PubMed ID:26950315

Download

Download PDF  'Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals'.
Preview
Content: Published Version
Filetype: PDF
Size: 652kB
View at publisher