HIV Infection Linked To Heart Attack Risk

Tuesday, March 5, 2013

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Editor's Choice
Academic Journal
Main Category: HIV / AIDS
Also Included In: Cardiovascular / Cardiology
Article Date: 05 Mar 2013 - 9:00 PST

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HIV infection is linked to a 50% increased risk of heart attack.

The finding came from a new study that involved data from over 82,000 veterans and was published in the journal JAMA Internal Medicine.

People infected with HIV (human immunodeficiency virus) have a longer lifespan and are at risk for cardiovascular disease because of the effectiveness of antiretroviral therapy (ART), according to the study background.

Previous research said that giving patients Abacavir for HIV treatment may significantly raise their likelihood of having a heart attack.

Whether HIV infection was associated with a higher probability of heart attack, also known as acute myocardial infarction (AMI), was investigated by a team from the University of Pittsburgh School of Medicine, led by Matthew S. Freiberg, M.D., M.Sc.

The research involved a large group of veterans infected with HIV and a comparable group of veterans not affected by HIV.

After analyzing data from 82,458 volunteers, results showed that during a median follow-up of 5.9 years, 871 AMI events occurred.

The researchers explained: "Across three decades of age, the mean ... AMI events per 1,000 person-years was consistently and significantly higher for HIV-positive compared with uninfected veterans."

For veterans between the ages of 40 and 49 years, heart attack events per 1,000 people per year were 2.0 for those infected with HIV and1.5 for those uninfected.

For ages 50 to 59, the events were 3.9 for those who were HIV-positive compared to 2.2 for those without HIV; and for ages 60 to 60, the events were 5.0 for those infected and 3.3 for those uninfected.

After adjusting the results for substance use, and co-existing conditions, and risk factors such as high blood pressure and cholesterol, veterans who were HIV-positive had a greater likelihood of incident AMI as opposed to the uninfected veterans.

The results indicated that an "excess risk" of heart attack remained among the HIV-positive people.

Since the participants were mostly men, the findings may not be generalizable to females, the experts pointed out.

Although the research showed an association between HIV and elevated risk of heart attack in the veterans, a cause-and-effect relationship was not demonstrated.

The authors said:

"In conclusion, HIV infection is independently associated with AMI after adjustment for Framingham risk, comorbidities and substance use. Unsuppressed HIV viremia, low CD4 cell count, Framingham risk factors, hepatitis C virus, renal disease and anemia are also associated with AMI."

More research on the link between HIV and Heart Attack is crucial

Patrick W.G. Mallon, M.B., B.Ch., Ph.D., F.R.A.C.P., F.R.C.P.I., of the University College Dublin, Ireland, wrote in an associated commentary:

"Although the cohort studied was almost exclusively male (>97 percent), the results demonstrate a clear and consistent excess risk of MI [myocardial infarction] (approximately 50 percent increase) in HIV-positive people across a range of age groups, with the association between HIV status and MI remaining significant when controlled for a number of covariates including traditional cardiovascular risk factors, such as lipids, blood pressure, and smoking status."

He continued: "That the HIV-positive cohort in the study by Freiberg et al experienced a 50 percent increased risk of MI highlights the need for further research in women, research into the underlying mechanisms of the increased risk, and the development of specific interventions to reduce the risk of MI in HIV-positive populations."

Written by Sarah Glynn
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

Visit our hiv / aids section for the latest news on this subject.
HIV Infection and the Risk of Acute Myocardial Infarction
Matthew S. Freiberg, MD, MSc et al
JAMA Internal Medicine 2013; doi:10.1001/jamainternmed.2013.3728
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06 Mar, 2013


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