Association of immunologic and virologic factors with myocardial infarction rates in a US healthcare system.
BACKGROUND
The effects of immunologic and virologic factors on acute myocardial infarction (AMI) rates in patients with HIV are unclear.


METHODS
HIV-infected patients in a US healthcare system were assessed for AMI.


RESULTS
Of 6517 patients with HIV, 273 (4.2%) had an AMI. In a model adjusting for cardiovascular risk factors, antiretroviral medications, and HIV parameters, CD4 count less than 200/mm (odds ratio, 1.74; 95% confidence interval, 1.07 to 2.81; P = 0.02) predicted AMI. Increased HIV viral load was associated with AMI accounting for cardiovascular disease risk factors and antiretroviral medications but was not significant when CD4 count was considered.


CONCLUSIONS
Immunologic control appears to be the most important HIV-related factor associated with AMI.
Triant
Virginia A
VA
Massachusetts General Hospital, Division of Infectious Diseases, Boston, MA 02114, USA. vtriant@partners.org
Regan
Susan
S
Lee
Hang
H
Sax
Paul E
PE
Meigs
James B
JB
Grinspoon
Steven K
SK
D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000821:virology; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000276:immunology* / Q000821:virology*; D012307:Risk Factors; D016896:Treatment Outcome; D019562:Viral Load
D019380:Anti-HIV Agents
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