Acute myocardial infarction rates and cardiovascular risk factors increased in patients with HIV disease
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A health-care system-based cohort study using a large data registry of 3851 HIV patients and 1,044,589 non-HIV patients was conducted to assess comparative acute myocardial infarction (AMI) rates and cardiovascular risk factors. AMI as defined by International Classification of Diseases coding criteria was the primary outcome. AMI rates per 1000 person years increased in HIV patients compared to non-HIV patients (11.13% vs 6.98%), the difference in AMI rates being significant with a relative risk of 1.75 (P<0.0001) after adjusting for gender and other risk factors. The unadjusted AMI rates per 1000 person years were higher for HIV patients among women but not among men. After adjusting for age, gender, race, hypertension, diabetes and dyslipidaemia, the relative risks were 2.98 for women and 1.40 for men. It should be noted that smoking was not included in the overall regression model, and part of the increased risk may be accounted for by differences in smoking rates, as smoking prevalence is higher in HIV subjects than in the general population. In conclusion, cardiac risk modification strategies appear to be of paramount importance for the long-term management of HIV patients.
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