title: History of AIDS in HIV-Infected Patients Is Associated With Higher In-Hospital Mortality Following Admission for Acute Myocardial Infarction and Stroke.
abstract: Although human immunodeficiency virus (HIV)-infected persons are at increased risk for major cardiovascular events, short-term prognosis after these events is unclear.
  
  
  
  To determine the association between HIV infection and acute myocardial infarction (AMI) and stroke outcomes, we analyzed hospital discharge data from the Nationwide Inpatient Sample (NIS) between 2002 and 2012. Multivariable logistic regression was used to evaluate the association between HIV infection and in-hospital death after AMI or stroke.
  
  
  
  Overall, 18 369 785 AMI/stroke hospitalizations were included in the analysis. Patients with a history of AIDS were significantly more likely than uninfected patients to die during hospitalization after admission for AMI or stroke (odds ratio, 3.03 [95% confidence interval {CI}, 1.71-5.38] for AMI and 2.59 [95% CI, 1.97-3.41] for stroke). Additionally, patients with AIDS were more likely than HIV-uninfected patients to be discharged to nonhospital inpatient facilities after admission for AMI (OR, 3.14 [95% CI, 1.72-5.74]) or stroke (OR, 1.45; 95% CI, 1.12-1.87). There was a minimal difference in either outcome between HIV-infected patients without a history of AIDS and uninfected patients.
  
  
  
  Patients with a history of AIDS were significantly more likely than uninfected patients to die during hospitalization after admission for AMI or stroke. This disparity was not observed when infected patients without a history of AIDS were compared to uninfected patients, implying that preserving immune function may improve cardiovascular outcomes in HIV-infected persons.
authors.affiliation: Division of Infectious Diseases, Department of Medicine.
authors.forename: Nwora Lance
authors.initials: NL
authors.lastname: Okeke
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of California, San Diego.
authors.forename: Charles B
authors.initials: CB
authors.lastname: Hicks
authors.affiliation: Division of Infectious Diseases, Department of Medicine.
authors.forename: Mehri S
authors.initials: MS
authors.lastname: McKellar
authors.affiliation: Division of Infectious Diseases, Department of Medicine School of Medicine, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Vance G
authors.initials: VG
authors.lastname: Fowler
authors.affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham Department of Health Policy and Management, Gillings School of Global Public Health School of Medicine, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Jerome J
authors.initials: JJ
authors.lastname: Federspiel
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000821:virology; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000821:virology; D011379:Prognosis; D020521:Stroke / Q000150:complications / Q000401:mortality* / Q000821:virology
keywords: HIV infection; acute myocardial infarction; cardiovascular disease; outcomes; stroke, hospital