title: Differences by HIV serostatus in coronary artery disease severity and likelihood of percutaneous coronary intervention following stress testing.
abstract: BACKGROUND
  HIV-infected persons develop coronary artery disease (CAD) more commonly and earlier than uninfected persons; however, the role of non-invasive testing to stratify CAD risk in HIV is not well defined.
  
  
  RESULTS
  Patients were selected from a single-center electronic cohort of HIV-infected patients and uninfected controls matched 1:2 on age, sex, race, and type of cardiovascular testing performed. Patients with abnormal echocardiographic or nuclear stress testing who subsequently underwent coronary angiography were included. Logistic regressions were used to assess differences by HIV serostatus in two co-primary endpoints: (1) severe CAD (≥70% stenosis of at least one coronary artery) and (2) performance of percutaneous coronary intervention (PCI). HIV-infected patients (N = 189) were significantly more likely to undergo PCI following abnormal stress test when compared with uninfected persons (N = 319) after adjustment for demographics, CAD risk factors, previous coronary intervention, and stress test type (OR 1.85, 95% CI 1.12-3.04, P = 0.003). No associations between HIV serostatus and CAD were statistically significant, although there was a non-significant trend toward greater CAD for HIV-infected patients.
  
  
  CONCLUSIONS
  HIV-infected patients with abnormal cardiovascular stress testing who underwent subsequent coronary angiography did not have a significantly greater CAD burden than uninfected controls, but were significantly more likely to receive PCI.
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 600, Chicago, IL, 60611, USA. matthewjfeinstein@northwestern.edu.|Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lakeshore Drive, Suite 1400, Chicago, IL, 60611, USA. matthewjfeinstein@northwestern.edu.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Feinstein
authors.affiliation: Department of Medicine, Beth Israel Deaconness Medical Center, Boston, MA, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Poole
authors.affiliation: Department of Medicine, Northwestern University Feinberg School of Medicine, 251 E. Huron, Suite 3-150, Chicago, IL, 60611, USA.
authors.forename: Pedro
authors.initials: P
authors.lastname: Engel Gonzalez
authors.affiliation: Northwestern Medicine Enterprise Data Warehouse, Chicago, IL, 60611, USA.
authors.forename: Anna E
authors.initials: AE
authors.lastname: Pawlowski
authors.affiliation: Northwestern Medicine Enterprise Data Warehouse, Chicago, IL, 60611, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Schneider
authors.affiliation: Division of Cardiovascular Diseases, Northwestern University Feinberg School of Medicine, 676 N. St. Clair, Suite 600, Chicago, IL, 60611, USA.
authors.forename: Tim S
authors.initials: TS
authors.lastname: Provias
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, 251 E. Huron St., Suite 3-150, Chicago, IL, 60611, USA.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Palella
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, 251 E. Huron St., Suite 3-150, Chicago, IL, 60611, USA.
authors.forename: Chad J
authors.initials: CJ
authors.lastname: Achenbach
authors.affiliation: Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lakeshore Drive, Suite 1400, Chicago, IL, 60611, USA.
authors.forename: Donald M
authors.initials: DM
authors.lastname: Lloyd-Jones
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D005080:Exercise Test; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012720:Severity of Illness Index
keywords: HIV; cardiovascular disease; chronic co-morbid illnesses in HIV infection; chronic complications of HIV; coronary artery disease; non-invasive cardiovascular testing