Abstract
OBJECTIVE: To investigate the association between abacavir (ABC) use and recurrent myocardial infarction (MI) among HIV-positive people with a prior MI.
DESIGN: International multi-cohort collaboration with follow-up from 1999-2016.
METHODS: The rate of recurrent MI was described among D:A:D participants who experienced an index MI whilst in the study, and who remained under follow-up beyond 28 days after this MI. Follow-up was considered to the date of next MI, death, 01/Feb/2016 or 6 months after last clinic visit. Poisson regression models considered associations between recurrent MI and exposure to ABC (use at index MI, current post-MI exposure and cumulative exposure), before and after adjusting for calendar year.
RESULTS: The 984 individuals who experienced an index MI during the study (91.3% male, median age 51 at index MI) were followed for 5312 person-years (PY) over which time there were 136 recurrent MIs (rate 2.56/100 PY, 95% Confidence Interval 2.13-2.99). Rates were 2.40 (1.71-3.09) and 2.65 (2.10-3.21)/100 PY in those who were and were not on ABC, respectively, at the index MI, and 2.90 (2.01-3.78) and 2.44 (1.95-2.93)/100 PY in those who were and were not currently receiving ABC, respectively, post-MI. No association was seen with recurrent MI and either cumulative exposure to ABC (RR=0.86 [0.68-1.10]/5 years), receipt of ABC at index MI (0.90 [0.63-1.29]) nor recent post-MI exposure to ABC (1.19 [0.82-1.71]).
CONCLUSIONS: Among people with a previous MI, there was no evidence for an association between use of ABC post-MI and an elevated risk of a recurrent MI.
Sabin, Caroline A