title: Renal impairment is associated with coronary heart disease in HIV-positive men.
abstract: BACKGROUND
  Chronic kidney disease is a risk factor for coronary heart disease (CHD). The association between renal impairment and CHD in HIV-positive patients remains poorly described.
  
  
  OBJECTIVE
  To describe the CHD incidence in a cohort of HIV-positive patients and to examine the relationship between reduced estimated glomerular filtration rate (eGFR) and incident CHD.
  
  
  METHODS
  We studied 7,828 HIV-positive patients who were followed up at 3 South London clinics between January 2004 and December 2009. CHD events were identified from electronic records and through elevated troponin levels. Multivariate Poisson regression analysis was used to identify factors associated with CHD among HIV-positive men.
  
  
  RESULTS
  The incidence of CHD among men was 1.2 (95% CI, 0.8-1.8) per 1,000 person-years of follow-up, with 28 patients (0.4%) having experienced 32 CHD events. In adjusted analyses, older age (incidence rate ratios [IRR], 2.81; 95% CI, 1.51-5.25) and hepatitis C virus (HCV) status (IRR, 3.94; 95% CI, 1.00-15.5) were significantly associated with CHD. Although eGFR as a continuous variable was not associated with CHD, an eGFR <75 mL/min remained associated with incident CHD (IRR, 4.30; 95% CI, 1.33-14.5) after adjustment for age. No association between CHD and abacavir exposure was observed (IRR, 0.94; 95% CI, 0.30-2.99).
  
  
  CONCLUSIONS
  The incidence of CHD in this ethnically diverse cohort was low. Our data suggest that impaired renal function identifies patients at increased risk of CHD events in whom management of traditional CHD risk factors should be prioritized.
authors.affiliation: School of Medicine, King's College, London, UK.
authors.forename: Lucy J
authors.initials: LJ
authors.lastname: Campbell
authors.forename: Mitesh
authors.initials: M
authors.lastname: Desai
authors.forename: Aseel
authors.initials: A
authors.lastname: Hegazi
authors.forename: Fowzia
authors.initials: F
authors.lastname: Ibrahim
authors.forename: Narbeh
authors.initials: N
authors.lastname: Melikian
authors.forename: Phillip
authors.initials: P
authors.lastname: Hay
authors.forename: Julie M
authors.initials: JM
authors.lastname: Fox
authors.forename: Frank A
authors.initials: FA
authors.lastname: Post
mesh_terms: D000328:Adult; D003324:Coronary Artery Disease / Q000209:etiology*; D005919:Glomerular Filtration Rate; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications*; D012307:Risk Factors