title: Outcomes after acute myocardial infarction in HIV-infected patients: analysis of data from a French nationwide hospital medical information database.
abstract: BACKGROUND
  We aimed to assess in-hospital case fatality and 1-year prognosis in HIV-infected patients with acute myocardial infarction.
  
  
  RESULTS
  From the PMSI (Program de Medicalisation des Systèmes d'informatique) database, data from 277 303 consecutive acute myocardial infarction patients hospitalized from January 1, 2005, to December 31, 2009, were analyzed. Surviving patients were followed up for 1 year after discharge. HIV-infected patients were compared with uninfected patients. Among the cohort, HIV-infected patients (n=608) accounted for 0.22%. All-cause hospital and 1-year mortality rates were lower in the HIV-infected group than in uninfected patients (3.1% versus 8.1% [P<0.001] and 1.4% versus 5.5% [P<0.001], respectively). From the database, we then analyzed a cohort derived from a matching procedure, with 1 HIV patient matched with 2 patients without HIV, based on age and sex (n=1824). Ischemic cardiomyopathy was more frequent in the HIV group (7.6% versus 4.2%, P=0.003). Hospitalization and 1-year mortality rates were similar in the 2 groups (3.1% versus 2.1% [P=0.168] and 1.4% versus 1.7% [P=0.642], respectively). However, at 12 months, hospitalizations for episodes of heart failure were significantly more frequent in HIV-infected than in uninfected patients (3.3% versus 1.4%, respectively; P=0.020). HIV infection, diabetes mellitus, history of ischemic cardiomyopathy, and undergoing percutaneous coronary intervention were associated in univariate analysis with occurrence of heart failure. By multivariable analysis, HIV infection (odds ratio 2.82, 95% confidence interval 1.32-6.01), diabetes mellitus, and undergoing percutaneous coronary intervention remained independent predictors of heart failure.
  
  
  CONCLUSIONS
  The present study demonstrates that after acute myocardial infarction, HIV status influences long-term risk, although the short-term risk in HIV patients is comparable to that in uninfected patients.
authors.affiliation: Department of Cardiology, University Hospital, Dijon, France. luc.lorgis@chu-dijon.fr
authors.forename: Luc
authors.initials: L
authors.lastname: Lorgis
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cottenet
authors.forename: Guillaume
authors.initials: G
authors.lastname: Molins
authors.forename: Eric
authors.initials: E
authors.lastname: Benzenine
authors.forename: Marianne
authors.initials: M
authors.lastname: Zeller
authors.forename: Hervé
authors.initials: H
authors.lastname: Aube
authors.forename: Claude
authors.initials: C
authors.lastname: Touzery
authors.forename: Joelle
authors.initials: J
authors.lastname: Hamblin
authors.forename: Aurélie
authors.initials: A
authors.lastname: Gudjoncik
authors.forename: Yves
authors.initials: Y
authors.lastname: Cottin
authors.forename: Catherine
authors.initials: C
authors.lastname: Quantin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008491:Medical Informatics Applications; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D013223:Statistics as Topic / Q000379:methods*; D016896:Treatment Outcome