Rates of cardiovascular disease following smoking cessation in patients with HIV infection: results from the D:A:D study(*)

TY - JOUR

T1 - Rates of cardiovascular disease following smoking cessation in patients with HIV infection

T2 - results from the D:A:D study(*)

AU - Petoumenos, K

AU - Worm, S

AU - Reiss, P

AU - de Wit, S

AU - d'Arminio Monforte, A

AU - Sabin, C

AU - Friis-Møller, N

AU - Weber, R

AU - Mercie, P

AU - Pradier, C

AU - El-Sadr, W

AU - Kirk, O

AU - Lundgren, J

AU - Law, Mg

AU - D:A:D Study Group

N1 - © 2011 British HIV Association.

PY - 2011/8

Y1 - 2011/8

N2 - Objectives: The aim of the study was to estimate the rates of cardiovascular disease (CVD) events after stopping smoking in patients with HIV infection. Methods: Patients who reported smoking status and no previous CVD prior to enrolment in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study were included in this study. Smoking status is collected at each visit as current smoker (yes/no) and ever smoker (yes/no). Time since stopping smoking was calculated for persons who had reported current smoking during follow-up and no current smoking subsequently. Endpoints were: myocardial infarction (MI); coronary heart disease (CHD: MI plus invasive coronary artery procedure or death from other CHD); CVD (CHD plus carotid artery endarterectomy or stroke); and all-cause mortality. Event rates were calculated for never, previous and current smokers, and smokers who stopped during follow-up. Incidence rate ratios (IRRs) were determined using Poisson regression adjusted for age, sex, cohort, calendar year, family history of CVD, diabetes, lipids, blood pressure and antiretroviral treatment. Results: A total of 27136 patients had smoking status reported, with totals of 432, 600, 746 and 1902 MI, CHD, CVD and mortality events, respectively. The adjusted IRR of CVD in patients who stopped smoking during follow-up decreased from 2.32 within the first year of stopping to 1.49 after >3 years compared with those who never smoked. Similar trends were observed for the MI and CHD endpoints. Reductions in risk were less pronounced for all-cause mortality. Conclusion: The risk of CVD events in HIV-positive patients decreased with increasing time since stopping smoking. Smoking cessation efforts should be a priority in the management of HIV-positive patients.

AB - Objectives: The aim of the study was to estimate the rates of cardiovascular disease (CVD) events after stopping smoking in patients with HIV infection. Methods: Patients who reported smoking status and no previous CVD prior to enrolment in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study were included in this study. Smoking status is collected at each visit as current smoker (yes/no) and ever smoker (yes/no). Time since stopping smoking was calculated for persons who had reported current smoking during follow-up and no current smoking subsequently. Endpoints were: myocardial infarction (MI); coronary heart disease (CHD: MI plus invasive coronary artery procedure or death from other CHD); CVD (CHD plus carotid artery endarterectomy or stroke); and all-cause mortality. Event rates were calculated for never, previous and current smokers, and smokers who stopped during follow-up. Incidence rate ratios (IRRs) were determined using Poisson regression adjusted for age, sex, cohort, calendar year, family history of CVD, diabetes, lipids, blood pressure and antiretroviral treatment. Results: A total of 27136 patients had smoking status reported, with totals of 432, 600, 746 and 1902 MI, CHD, CVD and mortality events, respectively. The adjusted IRR of CVD in patients who stopped smoking during follow-up decreased from 2.32 within the first year of stopping to 1.49 after >3 years compared with those who never smoked. Similar trends were observed for the MI and CHD endpoints. Reductions in risk were less pronounced for all-cause mortality. Conclusion: The risk of CVD events in HIV-positive patients decreased with increasing time since stopping smoking. Smoking cessation efforts should be a priority in the management of HIV-positive patients.

KW - Adult

KW - Argentina

KW - CD4 Lymphocyte Count

KW - Cardiovascular Diseases

KW - Cohort Studies

KW - Europe

KW - Female

KW - HIV Infections

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Risk Factors

KW - Smoking

KW - Smoking Cessation

KW - United States

U2 - 10.1111/j.1468-1293.2010.00901.x

DO - 10.1111/j.1468-1293.2010.00901.x

M3 - Journal article

C2 - 21251183

SN - 2161-5861

VL - 12

SP - 412

EP - 421

JO - Topics in antiviral medicine

JF - Topics in antiviral medicine

IS - 7

ER -