Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals

Camilla Ingrid Hatleberg; Lene Ryom Nielsen; Wafaa El-Sadr; Colette Smith; Rainer Weber; Peter Reiss; Eric Fontas; Francois Dabis; Matthew Law; Antonella d'Arminio Monforte; Stephane De Wit; Amanda Mocroft; Andrew Phillips; Jens D Lundgren; Caroline Sabin; D:A:D Study Group

doi:10.1097/QAD.0000000000001076

Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals

Camilla Ingrid Hatleberg, Lene Ryom Nielsen, Wafaa El-Sadr, Colette Smith, Rainer Weber, Peter Reiss, Eric Fontas, Francois Dabis, Matthew Law, Antonella d'Arminio Monforte, Stephane De Wit, Amanda Mocroft, Andrew Phillips, Jens D Lundgren, Caroline Sabin, D:A:D Study Group

Department of Immunology and Microbiology

8 Citations (Scopus)

Abstract

OBJECTIVE: Few studies have described mortality and clinical outcomes after myocardial infarction (MI) in the HIV-positive population. This study evaluated changes in short-term mortality after MI in HIV-positive individuals in the D:A:D Study, and investigated possible reasons for any changes seen.

DESIGN: Prospective cohort study.

METHODS: Demographic, cardiovascular disease (CVD)/HIV-related characteristics and CVD-related interventions (invasive cardiovascular procedures and drug interventions) were summarized at the time of and following an MI. Associations between calendar year and mortality in the first month after MI were identified using logistic regression with adjustment for confounders, including interventions received in the first month after MI.

RESULTS: One thousand and eight HIV-positive individuals experiencing an MI over the period 1999-2014 were included. The absolute number of MIs decreased from 214 (1999-2002) to 154 (2011-2014). Whilst the CVD risk profile remained high over time, the HIV status improved. The use of CVD-related interventions after MI appeared to increase over time. The proportion of individuals who died in the first month after MI dropped from 26.6% in 1999-2002 to 8.4% in 2011-2014. Later calendar year was associated with decreased short-term mortality; this effect was attenuated after adjusting for CVD-related interventions received in the first month after MI [odds ratio changed from 0.88 (95% confidence interval 0.83, 0.93) to 0.97 (0.91, 1.02)].

CONCLUSION: Improvements in short-term survival after MI appear to be largely driven by improved medical management of CVD risk in HIV-positive individuals after MI. Efforts are still needed to treat CVD risk factors and increase access to CVD-related interventions.

Original language	English
Journal	AIDS (London, England)
Volume	30
Issue number	10
Pages (from-to)	1583-1596
Number of pages	14
ISSN	0269-9370
DOIs	https://doi.org/10.1097/QAD.0000000000001076
Publication status	Published - 19 Jun 2016

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1097/QAD.0000000000001076

Cite this

Hatleberg, C. I., Nielsen, L. R., El-Sadr, W., Smith, C., Weber, R., Reiss, P., Fontas, E., Dabis, F., Law, M., Monforte, A. DA., De Wit, S., Mocroft, A., Phillips, A., Lundgren, J. D., Sabin, C., & D:A:D Study Group (2016). Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals. AIDS (London, England), 30(10), 1583-1596. https://doi.org/10.1097/QAD.0000000000001076

Hatleberg, CI, Nielsen, LR, El-Sadr, W, Smith, C, Weber, R, Reiss, P, Fontas, E, Dabis, F, Law, M, Monforte, ADA, De Wit, S, Mocroft, A, Phillips, A, Lundgren, JD, Sabin, C & D:A:D Study Group 2016, 'Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals', AIDS (London, England), vol. 30, no. 10, pp. 1583-1596. https://doi.org/10.1097/QAD.0000000000001076

@article{7ee6587d13c944da82b63895e2e267c3,

title = "Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals",

abstract = "OBJECTIVE: Few studies have described mortality and clinical outcomes after myocardial infarction (MI) in the HIV-positive population. This study evaluated changes in short-term mortality after MI in HIV-positive individuals in the D:A:D Study, and investigated possible reasons for any changes seen.DESIGN: Prospective cohort study.METHODS: Demographic, cardiovascular disease (CVD)/HIV-related characteristics and CVD-related interventions (invasive cardiovascular procedures and drug interventions) were summarized at the time of and following an MI. Associations between calendar year and mortality in the first month after MI were identified using logistic regression with adjustment for confounders, including interventions received in the first month after MI.RESULTS: One thousand and eight HIV-positive individuals experiencing an MI over the period 1999-2014 were included. The absolute number of MIs decreased from 214 (1999-2002) to 154 (2011-2014). Whilst the CVD risk profile remained high over time, the HIV status improved. The use of CVD-related interventions after MI appeared to increase over time. The proportion of individuals who died in the first month after MI dropped from 26.6% in 1999-2002 to 8.4% in 2011-2014. Later calendar year was associated with decreased short-term mortality; this effect was attenuated after adjusting for CVD-related interventions received in the first month after MI [odds ratio changed from 0.88 (95% confidence interval 0.83, 0.93) to 0.97 (0.91, 1.02)].CONCLUSION: Improvements in short-term survival after MI appear to be largely driven by improved medical management of CVD risk in HIV-positive individuals after MI. Efforts are still needed to treat CVD risk factors and increase access to CVD-related interventions.",

author = "Hatleberg, {Camilla Ingrid} and Nielsen, {Lene Ryom} and Wafaa El-Sadr and Colette Smith and Rainer Weber and Peter Reiss and Eric Fontas and Francois Dabis and Matthew Law and Monforte, {Antonella d'Arminio} and {De Wit}, Stephane and Amanda Mocroft and Andrew Phillips and Lundgren, {Jens D} and Caroline Sabin and {D:A:D Study Group}",

year = "2016",

month = jun,

day = "19",

doi = "10.1097/QAD.0000000000001076",

language = "English",

volume = "30",

pages = "1583--1596",

journal = "AIDS, Supplement",

issn = "1350-2840",

publisher = "Lippincott Williams & Wilkins",

number = "10",

}

TY - JOUR

T1 - Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals

AU - Hatleberg, Camilla Ingrid

AU - Nielsen, Lene Ryom

AU - El-Sadr, Wafaa

AU - Smith, Colette

AU - Weber, Rainer

AU - Reiss, Peter

AU - Fontas, Eric

AU - Dabis, Francois

AU - Law, Matthew

AU - Monforte, Antonella d'Arminio

AU - De Wit, Stephane

AU - Mocroft, Amanda

AU - Phillips, Andrew

AU - Lundgren, Jens D

AU - Sabin, Caroline

AU - D:A:D Study Group

PY - 2016/6/19

Y1 - 2016/6/19

N2 - OBJECTIVE: Few studies have described mortality and clinical outcomes after myocardial infarction (MI) in the HIV-positive population. This study evaluated changes in short-term mortality after MI in HIV-positive individuals in the D:A:D Study, and investigated possible reasons for any changes seen.DESIGN: Prospective cohort study.METHODS: Demographic, cardiovascular disease (CVD)/HIV-related characteristics and CVD-related interventions (invasive cardiovascular procedures and drug interventions) were summarized at the time of and following an MI. Associations between calendar year and mortality in the first month after MI were identified using logistic regression with adjustment for confounders, including interventions received in the first month after MI.RESULTS: One thousand and eight HIV-positive individuals experiencing an MI over the period 1999-2014 were included. The absolute number of MIs decreased from 214 (1999-2002) to 154 (2011-2014). Whilst the CVD risk profile remained high over time, the HIV status improved. The use of CVD-related interventions after MI appeared to increase over time. The proportion of individuals who died in the first month after MI dropped from 26.6% in 1999-2002 to 8.4% in 2011-2014. Later calendar year was associated with decreased short-term mortality; this effect was attenuated after adjusting for CVD-related interventions received in the first month after MI [odds ratio changed from 0.88 (95% confidence interval 0.83, 0.93) to 0.97 (0.91, 1.02)].CONCLUSION: Improvements in short-term survival after MI appear to be largely driven by improved medical management of CVD risk in HIV-positive individuals after MI. Efforts are still needed to treat CVD risk factors and increase access to CVD-related interventions.

AB - OBJECTIVE: Few studies have described mortality and clinical outcomes after myocardial infarction (MI) in the HIV-positive population. This study evaluated changes in short-term mortality after MI in HIV-positive individuals in the D:A:D Study, and investigated possible reasons for any changes seen.DESIGN: Prospective cohort study.METHODS: Demographic, cardiovascular disease (CVD)/HIV-related characteristics and CVD-related interventions (invasive cardiovascular procedures and drug interventions) were summarized at the time of and following an MI. Associations between calendar year and mortality in the first month after MI were identified using logistic regression with adjustment for confounders, including interventions received in the first month after MI.RESULTS: One thousand and eight HIV-positive individuals experiencing an MI over the period 1999-2014 were included. The absolute number of MIs decreased from 214 (1999-2002) to 154 (2011-2014). Whilst the CVD risk profile remained high over time, the HIV status improved. The use of CVD-related interventions after MI appeared to increase over time. The proportion of individuals who died in the first month after MI dropped from 26.6% in 1999-2002 to 8.4% in 2011-2014. Later calendar year was associated with decreased short-term mortality; this effect was attenuated after adjusting for CVD-related interventions received in the first month after MI [odds ratio changed from 0.88 (95% confidence interval 0.83, 0.93) to 0.97 (0.91, 1.02)].CONCLUSION: Improvements in short-term survival after MI appear to be largely driven by improved medical management of CVD risk in HIV-positive individuals after MI. Efforts are still needed to treat CVD risk factors and increase access to CVD-related interventions.

U2 - 10.1097/QAD.0000000000001076

DO - 10.1097/QAD.0000000000001076

M3 - Journal article

C2 - 26950315

SN - 1350-2840

VL - 30

SP - 1583

EP - 1596

JO - AIDS, Supplement

JF - AIDS, Supplement

IS - 10

ER -

Improvements over time in short-term mortality following myocardial infarction in HIV-positive individuals

Abstract

UN SDGs

Access to Document

Fingerprint

Cite this