Aspirin Use for Primary and Secondary Prevention in Human Immunodeficiency Virus (HIV)-Infected and HIV-Uninfected Patients.
BACKGROUND
Human immunodeficiency virus (HIV) infection is associated with increased risk of myocardial infarction (MI). The use of aspirin for primary and secondary MI prevention in HIV infection has not been extensively studied.


METHODS
We performed a cross-sectional study of 4037 patients infected with HIV and 36 338 demographics-matched control patients in the Partners HealthCare System HIV cohort. We developed an algorithm to ascertain rates of nonepisodic acetylsalicylic acid (ASA) use using medication and electronic health record free text data. We assessed rates of ASA use among HIV-infected and HIV-uninfected (negative) patients with and without coronary heart disease (CHD).


RESULTS
Rates of ASA use were lower among HIV-infected compared with HIV-uninfected patients (12.4% vs 15.3%, P < .001), with a relatively greater difference among patients with ≥2 CHD risk factors (22.1% vs 42.4%, P < .001). This finding was present among men and among patients in the 30-39 and 40-49 age groups. Among patients with prevalent CHD using ASA for secondary prevention, rates of ASA use were also lower among HIV-infected patients compared with HIV-uninfected patients (51.6% vs 65.4%, P < .001).


CONCLUSIONS
Rates of ASA use were lower among HIV-infected patients compared with controls, with a greater relative difference among those with elevated CHD risk and those with known CHD. Further studies are needed to investigate the optimal strategies for ASA use among patients infected with HIV.
Division of Infectious Diseases , Brigham and Women's Hospital , Boston, Massachusetts ; Division of Infectious Diseases.
Sujit
S
Suchindran
Division of General Internal Medicine.
Susan
S
Regan
Division of General Internal Medicine.
James B
JB
Meigs
Program in Nutritional Metabolism , Massachusetts General Hospital , Boston.
Steven K
SK
Grinspoon
Division of Infectious Diseases ; Division of General Internal Medicine.
Virginia A
VA
Triant
HIV; aspirin; coronary disease; prevention; primary care