Diabetes mellitus, preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study)

Signe W Worm; Stephane De Wit; Rainer Weber; Caroline A Sabin; Peter Reiss; Wafaa El-Sadr; Antonella D'Arminio Monforte; Ole Kirk; Eric Fontas; Francois Dabis; Matthew G Law; Jens Lundgren; Nina Friis-Møller

doi:10.1161/CIRCULATIONAHA.108.790857

Diabetes mellitus, preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study)

Signe W Worm, Stephane De Wit, Rainer Weber, Caroline A Sabin, Peter Reiss, Wafaa El-Sadr, Antonella D'Arminio Monforte, Ole Kirk, Eric Fontas, Francois Dabis, Matthew G Law, Jens Lundgren, Nina Friis-Møller

73 Citations (Scopus)

Abstract

BACKGROUND: Although guidelines in individuals not infected with the human immunodeficiency virus (HIV) consider diabetes mellitus (DM) to be a coronary heart disease (CHD) equivalent, there is little information on its association with CHD in those infected with HIV. We investigated the impact of DM and preexisting CHD on the development of a new CHD episode among 33,347 HIV-infected individuals in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study). METHODS AND RESULTS: Over 159,971 person-years, 698 CHD events occurred. After adjustment for gender, age, cohort, HIV transmission, ethnicity, family history of CHD, smoking, and calendar year, the rate of a CHD episode was 7.52 times higher (Poisson regression, 95% CI 6.02 to 9.39, P=0.0001) in those with preexisting CHD than in those without preexisting CHD, but it was only 2.41 times higher (95% CI 1.91 to 3.05, P=0.0001) in those with preexisting DM compared with those without DM. No statistical interactions were apparent between either diagnosis and sex; although older people with DM had an increased CHD rate compared with younger people, older people with preexisting CHD had a lower event rate. A statistically significant interaction between preexisting DM and CHD (P=0.003) suggested that the CHD rate in those with preexisting CHD and DM is lower than expected on the basis of the main effects alone. CONCLUSIONS: DM and preexisting CHD are both important risk factors for CHD events in HIV-infected individuals. There is a need for targeted interventions to reduce the risk of CHD in both high-risk groups of HIV-infected individuals.

Original language	English
Journal	Circulation
Volume	119
Issue number	6
Pages (from-to)	805-11
Number of pages	6
ISSN	0009-7322
DOIs	https://doi.org/10.1161/CIRCULATIONAHA.108.790857
Publication status	Published - 2009

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Worm, S. W., De Wit, S., Weber, R., Sabin, C. A., Reiss, P., El-Sadr, W., Monforte, A. DA., Kirk, O., Fontas, E., Dabis, F., Law, M. G., Lundgren, J., & Friis-Møller, N. (2009). Diabetes mellitus, preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study). Circulation, 119(6), 805-11. https://doi.org/10.1161/CIRCULATIONAHA.108.790857

Diabetes mellitus, preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study). / Worm, Signe W; De Wit, Stephane; Weber, Rainer et al.

In: Circulation, Vol. 119, No. 6, 2009, p. 805-11.

Research output: Contribution to journal › Journal article › Research › peer-review

Worm, SW, De Wit, S, Weber, R, Sabin, CA, Reiss, P, El-Sadr, W, Monforte, ADA, Kirk, O, Fontas, E, Dabis, F, Law, MG, Lundgren, J & Friis-Møller, N 2009, 'Diabetes mellitus, preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study)', Circulation, vol. 119, no. 6, pp. 805-11. https://doi.org/10.1161/CIRCULATIONAHA.108.790857

Worm SW, De Wit S, Weber R, Sabin CA, Reiss P, El-Sadr W et al. Diabetes mellitus, preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study). Circulation. 2009;119(6):805-11. doi: 10.1161/CIRCULATIONAHA.108.790857

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title = "Diabetes mellitus, preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study)",

abstract = "BACKGROUND: Although guidelines in individuals not infected with the human immunodeficiency virus (HIV) consider diabetes mellitus (DM) to be a coronary heart disease (CHD) equivalent, there is little information on its association with CHD in those infected with HIV. We investigated the impact of DM and preexisting CHD on the development of a new CHD episode among 33,347 HIV-infected individuals in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study). METHODS AND RESULTS: Over 159,971 person-years, 698 CHD events occurred. After adjustment for gender, age, cohort, HIV transmission, ethnicity, family history of CHD, smoking, and calendar year, the rate of a CHD episode was 7.52 times higher (Poisson regression, 95% CI 6.02 to 9.39, P=0.0001) in those with preexisting CHD than in those without preexisting CHD, but it was only 2.41 times higher (95% CI 1.91 to 3.05, P=0.0001) in those with preexisting DM compared with those without DM. No statistical interactions were apparent between either diagnosis and sex; although older people with DM had an increased CHD rate compared with younger people, older people with preexisting CHD had a lower event rate. A statistically significant interaction between preexisting DM and CHD (P=0.003) suggested that the CHD rate in those with preexisting CHD and DM is lower than expected on the basis of the main effects alone. CONCLUSIONS: DM and preexisting CHD are both important risk factors for CHD events in HIV-infected individuals. There is a need for targeted interventions to reduce the risk of CHD in both high-risk groups of HIV-infected individuals.",

author = "Worm, {Signe W} and {De Wit}, Stephane and Rainer Weber and Sabin, {Caroline A} and Peter Reiss and Wafaa El-Sadr and Monforte, {Antonella D'Arminio} and Ole Kirk and Eric Fontas and Francois Dabis and Law, {Matthew G} and Jens Lundgren and Nina Friis-M{\o}ller",

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doi = "10.1161/CIRCULATIONAHA.108.790857",

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T1 - Diabetes mellitus, preexisting coronary heart disease, and the risk of subsequent coronary heart disease events in patients infected with human immunodeficiency virus: the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study)

AU - Worm, Signe W

AU - De Wit, Stephane

AU - Weber, Rainer

AU - Sabin, Caroline A

AU - Reiss, Peter

AU - El-Sadr, Wafaa

AU - Monforte, Antonella D'Arminio

AU - Kirk, Ole

AU - Fontas, Eric

AU - Dabis, Francois

AU - Law, Matthew G

AU - Lundgren, Jens

AU - Friis-Møller, Nina

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Although guidelines in individuals not infected with the human immunodeficiency virus (HIV) consider diabetes mellitus (DM) to be a coronary heart disease (CHD) equivalent, there is little information on its association with CHD in those infected with HIV. We investigated the impact of DM and preexisting CHD on the development of a new CHD episode among 33,347 HIV-infected individuals in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study). METHODS AND RESULTS: Over 159,971 person-years, 698 CHD events occurred. After adjustment for gender, age, cohort, HIV transmission, ethnicity, family history of CHD, smoking, and calendar year, the rate of a CHD episode was 7.52 times higher (Poisson regression, 95% CI 6.02 to 9.39, P=0.0001) in those with preexisting CHD than in those without preexisting CHD, but it was only 2.41 times higher (95% CI 1.91 to 3.05, P=0.0001) in those with preexisting DM compared with those without DM. No statistical interactions were apparent between either diagnosis and sex; although older people with DM had an increased CHD rate compared with younger people, older people with preexisting CHD had a lower event rate. A statistically significant interaction between preexisting DM and CHD (P=0.003) suggested that the CHD rate in those with preexisting CHD and DM is lower than expected on the basis of the main effects alone. CONCLUSIONS: DM and preexisting CHD are both important risk factors for CHD events in HIV-infected individuals. There is a need for targeted interventions to reduce the risk of CHD in both high-risk groups of HIV-infected individuals.

AB - BACKGROUND: Although guidelines in individuals not infected with the human immunodeficiency virus (HIV) consider diabetes mellitus (DM) to be a coronary heart disease (CHD) equivalent, there is little information on its association with CHD in those infected with HIV. We investigated the impact of DM and preexisting CHD on the development of a new CHD episode among 33,347 HIV-infected individuals in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D Study). METHODS AND RESULTS: Over 159,971 person-years, 698 CHD events occurred. After adjustment for gender, age, cohort, HIV transmission, ethnicity, family history of CHD, smoking, and calendar year, the rate of a CHD episode was 7.52 times higher (Poisson regression, 95% CI 6.02 to 9.39, P=0.0001) in those with preexisting CHD than in those without preexisting CHD, but it was only 2.41 times higher (95% CI 1.91 to 3.05, P=0.0001) in those with preexisting DM compared with those without DM. No statistical interactions were apparent between either diagnosis and sex; although older people with DM had an increased CHD rate compared with younger people, older people with preexisting CHD had a lower event rate. A statistically significant interaction between preexisting DM and CHD (P=0.003) suggested that the CHD rate in those with preexisting CHD and DM is lower than expected on the basis of the main effects alone. CONCLUSIONS: DM and preexisting CHD are both important risk factors for CHD events in HIV-infected individuals. There is a need for targeted interventions to reduce the risk of CHD in both high-risk groups of HIV-infected individuals.

U2 - 10.1161/CIRCULATIONAHA.108.790857

DO - 10.1161/CIRCULATIONAHA.108.790857

M3 - Journal article

C2 - 19188509

SN - 0009-7322

VL - 119

SP - 805

EP - 811

JO - Circulation

JF - Circulation

IS - 6

ER -