title: Association of immunologic and virologic factors with myocardial infarction rates in a US healthcare system.
abstract: 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.
authors.affiliation: Massachusetts General Hospital, Division of Infectious Diseases, Boston, MA 02114, USA. vtriant@partners.org
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Triant
authors.forename: Susan
authors.initials: S
authors.lastname: Regan
authors.forename: Hang
authors.initials: H
authors.lastname: Lee
authors.forename: Paul E
authors.initials: PE
authors.lastname: Sax
authors.forename: James B
authors.initials: JB
authors.lastname: Meigs
authors.forename: Steven K
authors.initials: SK
authors.lastname: Grinspoon
mesh_terms: 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
chemical_list: D019380:Anti-HIV Agents
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