Insomnia confers elevated risk for type 2 MI in patients with HIV
Among individuals living with HIV, those with insomnia had greater risk for type 2 MI, but not type 1 MI, than those without it.
In a cohort of 10,948 people living with HIV (mean age, 43 years; 15% women), insomnia conferred a 67% increased risk for type 2 MI after adjustment for demographic characteristics and a 49% increased risk after further adjustment for clinical characteristics, researchers reported at CROI.
However, there was no relationship between type 1 MI and insomnia in patients living with HIV.
“We did not find any association between insomnia and type 1 MI among people living with HIV,” Bridget M. Whitney, MPH, PhD student in the department of epidemiology at the University of Washington, Seattle, said during the presentation. “However, we did find an increased risk of type 2 MI among people living with HIV with insomnia compared to those without insomnia. While this association was slightly attenuated by adjustment for potentially important confounders, a 50% increased hazard of type 2 MI remained, indicating that this is likely a real association and not due completely to unmeasured or residual confounding.”
Researchers evaluated clinical data from five sites part of the Centers for AIDS Research Network of Integrated Clinical Systems cohort between 2005 and 2019 to assess the potential relationship between insomnia and first incident MI in patients living with HIV. Type 1 MI was defined as MI due to atherothrombotic coronary plaque rupture and type 2 MI from supply-demand mismatch caused by sepsis, stimulant use or other factors.
“These findings highlight the importance of distinguishing types, especially among people living with HIV, and how pooling of type 1 and type 2 could be inappropriate,” Whitney said during the presentation. “Further investigation into the relationship between insomnia and type 2 MI cause may elucidate mechanisms underlying this association.” – by Scott Buzby
Reference:
Whitney BM, et al. Abstract 644. Presented at: Conference on Retroviruses and Opportunistic Infections; March 8-11, 2020; Boston.
Disclosure: Whitney reports no relevant financial disclosures.