History of AIDS in HIV-Infected Patients Is Associated With Higher In-Hospital Mortality Following Admission for Acute Myocardial Infarction and Stroke. (3rd March 2016)

• Record Type: Journal Article
• Authors: Okeke, Nwora Lance; Hicks, Charles B.; McKellar, Mehri S.; Fowler, Vance G.; Federspiel, Jerome J.
• Is Part Of: Journal of infectious diseases. Volume 213:Number 12(2016:Jun. 15)
• Page Start: 1955
• Page End: 1961
• Publication Date: 2016-03-03
• Subjects: HIV infection -- cardiovascular disease -- acute myocardial infarction -- stroke, hospital -- outcomes; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiw082
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background. Although human immunodeficiency virus (HIV)–infected persons are at increased risk for major cardiovascular events, short-term prognosis after these events is unclear. Methods. 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. Results. 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. Conclusions. 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.