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Aspirin use lowest among HIV patients at increased risk for MI

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ATLANTA — Patients with HIV who are at increased risk for myocardial infarction have a lower likelihood of aspirin use to prevent cardiovascular disease complications. Therefore, researchers recommend for further studies to assess optimal indications and strategies for aspirin use among this population.

“There’s a lot of accumulating evidence that HIV patients have higher risk for cardiovascular disease, and the underlying reasons for these higher rates are receiving a lot of ongoing attention [at the 2013 Conference on Retroviruses and Opportunistic Infections,]” Sujit Suchindran, MD, of Massachusetts General Hospital in Boston, said during a press conference here. “We looked at whether or not HIV patients use aspirin the same amount as non-HIV patients.”

Overall, aspirin use was lower among those with HIV vs. those without HIV (12.4% vs. 15.3%; P<.001). There was a greater relative difference among those with significant cardiovascular disease risk.

In particular, aspirin use among those with HIV and with zero to one cardiovascular disease risk factors was 5.5% vs. 6.7% among those without HIV (P=.037). Among those with two or more cardiovascular disease risk factors, aspirin use was 22.1% among those with HIV and 42.4% among those without HIV (P<.001).

In a multivariate model that controlled for traditional risk factors, aspirin use was not associated with decreased risk for MI among those with HIV (HR=0.97; 95% CI, 0.64-1.49), whereas aspirin use was associated with a significant decreased risk for MI among those without HIV (HR=0.29; 95% CI, 0.24-0.34).

The study included 3,698 patients with HIV compared with 33,348 matched patients without HIV. Cardiovascular disease risk was unknown at baseline among all study participants.

“We found that aspirin use was lower in HIV patients and in particular among those who are at highest risk for MI,” Suchindran said. “This might speak to the lack of emphasis on chronic disease complications by HIV providers and also notably there are no particular guidelines for aspirin use among HIV patients.”

For more information:

Suchindran S. #65. Presented at: 2013 Conference on Retroviruses and Opportunistic Infections; March 3-6; Atlanta.

Disclosure: Suchindran reports no relevant financial disclosures.