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Patients with HIV may require PCI at younger age

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WASHINGTON — Patients with HIV have an increased risk for CHD and acute MI and may require PCI at a younger age, according to research presented at the American College of Cardiology Scientific Session.

“This is substantial evidence to support more vigilant risk factor modification in those with HIV, and more stringent — both earlier and more specific — CHD-screening methods for those with HIV,” Hany Abdallah, MD, and Farid Gholitabar, MD, both second-year residents at Icahn School of Medicine at Mount Sinai, and colleagues wrote in an abstract.

Researchers collected data from the 2013 National Inpatient Sample. The retrospective cohort study included 500,600 participants aged older than 18 years who underwent PCI. Of those, 1,150 (0.23%; 15.7% women) had HIV. The primary outcome was the participant age at first PCI.

Hany Abdallah

Adjustments were made for the following factors: type 2 diabetes including complications, sex, hypertension, hyperlipidemia, obesity and smoking.

“Here, we found that about 53% [of participants] had smoked. In some studies, it had been shown about 70% of HIV patients or more, depending on geographic areas and other factors, … smoked,” Abdallah said during the presentation.

The mean age of participants who did not have HIV was 65 years vs. 55 years for participants with HIV.

Participants with HIV who had their first PCI were, on average, 9 years younger compared with those without HIV.

“There is evidence that the HIV increases the risk of CHD independent of other risk factors,” Abdallah and colleagues wrote.

“HIV … while there are no CD4 epitopes on cardiomyocytes, certain inflammatory markers can change the vasculature in the heart to let it invite HIV into the heart itself and create this inflammatory process that accelerates atherosclerosis,” Abdallah said. – by Darlene Dobkowski

Reference:

Abdallah H, et al. Abstract 1138M-07. Presented at: American College of Cardiology Scientific Session; March 17-19, 2017; Washington, D.C.

Disclosure: Abdallah and Gholitabar report no relevant financial disclosures.