Myocardial infarction among Danish HIV-infected individuals: population-attributable fractions associated with smoking

Line D Rasmussen; Marie Helleberg; Margaret T May; Shoaib Afzal; Gitte Kronborg; Carsten S Larsen; Court Pedersen; Jan Gerstoft; Børge G Nordestgaard; Niels Obel

doi:10.1093/cid/civ013

Myocardial infarction among Danish HIV-infected individuals: population-attributable fractions associated with smoking

Line D Rasmussen, Marie Helleberg, Margaret T May, Shoaib Afzal, Gitte Kronborg, Carsten S Larsen, Court Pedersen, Jan Gerstoft, Børge G Nordestgaard, Niels Obel

Department of Clinical Medicine

81 Citations (Scopus)

Abstract

BACKGROUND: Human immunodeficiency virus-infected individuals have increased risk of myocardial infarction (MI); however, the contribution from smoking and potentiating effects of HIV are controversial.

METHODS: From the Danish HIV Cohort Study and the Copenhagen General Population Study, we identified 3251 HIV-infected individuals and 13 004 population controls matched on age and gender. Data on MI were obtained from the National Hospital Registry and the National Registry of Causes of Death. We calculated adjusted incidence rate ratios (aIRR) for risk of MI and population-attributable fractions (PAF) of MI associated with smoking.

RESULTS: In never smokers, HIV was not associated with an increased risk of MI (aIRR, 1.01; 95% confidence interval [CI], .41-2.54). In previous and current smokers, HIV was associated with a substantially increased risk of MI (aIRR, 1.78; 95% CI, .75-4.24 and aIRR, 2.83; 95% CI, 1.71-4.70). The PAF associated with ever smoking (previous or current) was 72% (95% CI, 55%-82%) for HIV-infected individuals and 24% (95% CI, 3%-40%) for population controls. If all current smokers stopped smoking, 42% (95% CI, 21%-57%) and 21% (95% CI, 12%-28%) of all MIs could potentially be avoided in these 2 populations.

CONCLUSIONS: Smoking is associated with a higher risk of MI in the HIV-infected population than in the general population. Approximately 3 of 4 MIs among HIV-infected individuals are associated with ever smoking compared with only 1 of 4 MIs among population controls. Smoking cessation could potentially prevent more than 40% of MIs among HIV-infected individuals, and smoking cessation should be a primary focus in modern HIV care.

Original language	English
Journal	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume	60
Issue number	9
Pages (from-to)	1415-23
Number of pages	9
ISSN	1058-4838
DOIs	https://doi.org/10.1093/cid/civ013
Publication status	Published - 1 May 2015

Keywords

Adult
Cohort Studies
Denmark
Female
HIV Infections
Humans
Incidence
Male
Middle Aged
Myocardial Infarction
Prospective Studies
Registries
Risk Assessment
Risk Factors
Smoking
Smoking Cessation
Time Factors

UN SDGs

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

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Cite this

Rasmussen, L. D., Helleberg, M., May, M. T., Afzal, S., Kronborg, G., Larsen, C. S., Pedersen, C., Gerstoft, J., Nordestgaard, B. G., & Obel, N. (2015). Myocardial infarction among Danish HIV-infected individuals: population-attributable fractions associated with smoking. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 60(9), 1415-23. https://doi.org/10.1093/cid/civ013

Myocardial infarction among Danish HIV-infected individuals: population-attributable fractions associated with smoking. / Rasmussen, Line D; Helleberg, Marie; May, Margaret T et al.
In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol. 60, No. 9, 01.05.2015, p. 1415-23.

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

Rasmussen, LD, Helleberg, M, May, MT, Afzal, S, Kronborg, G, Larsen, CS, Pedersen, C, Gerstoft, J , Nordestgaard, BG & Obel, N 2015, 'Myocardial infarction among Danish HIV-infected individuals: population-attributable fractions associated with smoking', Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, vol. 60, no. 9, pp. 1415-23. https://doi.org/10.1093/cid/civ013

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title = "Myocardial infarction among Danish HIV-infected individuals: population-attributable fractions associated with smoking",

abstract = "BACKGROUND: Human immunodeficiency virus-infected individuals have increased risk of myocardial infarction (MI); however, the contribution from smoking and potentiating effects of HIV are controversial.METHODS: From the Danish HIV Cohort Study and the Copenhagen General Population Study, we identified 3251 HIV-infected individuals and 13 004 population controls matched on age and gender. Data on MI were obtained from the National Hospital Registry and the National Registry of Causes of Death. We calculated adjusted incidence rate ratios (aIRR) for risk of MI and population-attributable fractions (PAF) of MI associated with smoking.RESULTS: In never smokers, HIV was not associated with an increased risk of MI (aIRR, 1.01; 95% confidence interval [CI], .41-2.54). In previous and current smokers, HIV was associated with a substantially increased risk of MI (aIRR, 1.78; 95% CI, .75-4.24 and aIRR, 2.83; 95% CI, 1.71-4.70). The PAF associated with ever smoking (previous or current) was 72% (95% CI, 55%-82%) for HIV-infected individuals and 24% (95% CI, 3%-40%) for population controls. If all current smokers stopped smoking, 42% (95% CI, 21%-57%) and 21% (95% CI, 12%-28%) of all MIs could potentially be avoided in these 2 populations.CONCLUSIONS: Smoking is associated with a higher risk of MI in the HIV-infected population than in the general population. Approximately 3 of 4 MIs among HIV-infected individuals are associated with ever smoking compared with only 1 of 4 MIs among population controls. Smoking cessation could potentially prevent more than 40% of MIs among HIV-infected individuals, and smoking cessation should be a primary focus in modern HIV care.",

keywords = "Adult, Cohort Studies, Denmark, Female, HIV Infections, Humans, Incidence, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Registries, Risk Assessment, Risk Factors, Smoking, Smoking Cessation, Time Factors",

author = "Rasmussen, {Line D} and Marie Helleberg and May, {Margaret T} and Shoaib Afzal and Gitte Kronborg and Larsen, {Carsten S} and Court Pedersen and Jan Gerstoft and Nordestgaard, {B{\o}rge G} and Niels Obel",

note = "{\textcopyright} The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].",

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doi = "10.1093/cid/civ013",

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T1 - Myocardial infarction among Danish HIV-infected individuals

T2 - population-attributable fractions associated with smoking

AU - Rasmussen, Line D

AU - Helleberg, Marie

AU - May, Margaret T

AU - Afzal, Shoaib

AU - Kronborg, Gitte

AU - Larsen, Carsten S

AU - Pedersen, Court

AU - Gerstoft, Jan

AU - Nordestgaard, Børge G

AU - Obel, Niels

PY - 2015/5/1

Y1 - 2015/5/1

N2 - BACKGROUND: Human immunodeficiency virus-infected individuals have increased risk of myocardial infarction (MI); however, the contribution from smoking and potentiating effects of HIV are controversial.METHODS: From the Danish HIV Cohort Study and the Copenhagen General Population Study, we identified 3251 HIV-infected individuals and 13 004 population controls matched on age and gender. Data on MI were obtained from the National Hospital Registry and the National Registry of Causes of Death. We calculated adjusted incidence rate ratios (aIRR) for risk of MI and population-attributable fractions (PAF) of MI associated with smoking.RESULTS: In never smokers, HIV was not associated with an increased risk of MI (aIRR, 1.01; 95% confidence interval [CI], .41-2.54). In previous and current smokers, HIV was associated with a substantially increased risk of MI (aIRR, 1.78; 95% CI, .75-4.24 and aIRR, 2.83; 95% CI, 1.71-4.70). The PAF associated with ever smoking (previous or current) was 72% (95% CI, 55%-82%) for HIV-infected individuals and 24% (95% CI, 3%-40%) for population controls. If all current smokers stopped smoking, 42% (95% CI, 21%-57%) and 21% (95% CI, 12%-28%) of all MIs could potentially be avoided in these 2 populations.CONCLUSIONS: Smoking is associated with a higher risk of MI in the HIV-infected population than in the general population. Approximately 3 of 4 MIs among HIV-infected individuals are associated with ever smoking compared with only 1 of 4 MIs among population controls. Smoking cessation could potentially prevent more than 40% of MIs among HIV-infected individuals, and smoking cessation should be a primary focus in modern HIV care.

AB - BACKGROUND: Human immunodeficiency virus-infected individuals have increased risk of myocardial infarction (MI); however, the contribution from smoking and potentiating effects of HIV are controversial.METHODS: From the Danish HIV Cohort Study and the Copenhagen General Population Study, we identified 3251 HIV-infected individuals and 13 004 population controls matched on age and gender. Data on MI were obtained from the National Hospital Registry and the National Registry of Causes of Death. We calculated adjusted incidence rate ratios (aIRR) for risk of MI and population-attributable fractions (PAF) of MI associated with smoking.RESULTS: In never smokers, HIV was not associated with an increased risk of MI (aIRR, 1.01; 95% confidence interval [CI], .41-2.54). In previous and current smokers, HIV was associated with a substantially increased risk of MI (aIRR, 1.78; 95% CI, .75-4.24 and aIRR, 2.83; 95% CI, 1.71-4.70). The PAF associated with ever smoking (previous or current) was 72% (95% CI, 55%-82%) for HIV-infected individuals and 24% (95% CI, 3%-40%) for population controls. If all current smokers stopped smoking, 42% (95% CI, 21%-57%) and 21% (95% CI, 12%-28%) of all MIs could potentially be avoided in these 2 populations.CONCLUSIONS: Smoking is associated with a higher risk of MI in the HIV-infected population than in the general population. Approximately 3 of 4 MIs among HIV-infected individuals are associated with ever smoking compared with only 1 of 4 MIs among population controls. Smoking cessation could potentially prevent more than 40% of MIs among HIV-infected individuals, and smoking cessation should be a primary focus in modern HIV care.

KW - Adult

KW - Cohort Studies

KW - Denmark

KW - Female

KW - HIV Infections

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Myocardial Infarction

KW - Prospective Studies

KW - Registries

KW - Risk Assessment

KW - Risk Factors

KW - Smoking

KW - Smoking Cessation

KW - Time Factors

U2 - 10.1093/cid/civ013

DO - 10.1093/cid/civ013

M3 - Journal article

C2 - 25595744

SN - 1058-4838

VL - 60

SP - 1415

EP - 1423

JO - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

IS - 9

ER -

Myocardial infarction among Danish HIV-infected individuals: population-attributable fractions associated with smoking

Abstract

Keywords

UN SDGs

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