title: Protease inhibitors and cardiovascular outcomes in patients with HIV-1.
abstract: Protease inhibitors for treatment of HIV-1 have been linked with increased risk of hyperlipidaemia and hyperglycaemia. In a cohort of 5672 outpatients with HIV-1 seen at nine US HIV clinics between January, 1993, and January, 2002, the frequency of myocardial infarctions increased after the introduction of protease inhibitors in 1996 (test for trend, p=0.0125). We noted that 19 of 3247 patients taking, but only two of 2425 who did not take, protease inhibitors had a myocardial infarction (odds ratio 7.1, 95% CI 1.6-44.3; Cox proportional hazards model-adjusted for smoking, sex, age, diabetes, hyperlipidaemia, and hypertension-hazard ratio 6.5, 0.9-47.8). Our findings suggest that, although infrequent, use of protease inhibitors is associated with increased risk of myocardial infarction in patients with HIV-1.
authors.affiliation: Division of HIV/AIDS Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA. sdh1@cdc.gov
authors.forename: Scott D
authors.initials: SD
authors.lastname: Holmberg
authors.forename: Anne C
authors.initials: AC
authors.lastname: Moorman
authors.forename: John M
authors.initials: JM
authors.lastname: Williamson
authors.forename: Tony C
authors.initials: TC
authors.lastname: Tong
authors.forename: Douglas J
authors.initials: DJ
authors.lastname: Ward
authors.forename: Kathy C
authors.initials: KC
authors.lastname: Wood
authors.forename: Alan E
authors.initials: AE
authors.lastname: Greenberg
authors.forename: Robert S
authors.initials: RS
authors.lastname: Janssen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced*; D016016:Proportional Hazards Models; D011480:Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D011480:Protease Inhibitors