HIV-Positive Status Increased Risk for Acute MI by Almost 50%

Veterans infected with HIV had a 48% increased risk of acute myocardial infarction (AMI) compared with uninfected veterans, even after adjustment for Framingham risk factors, comorbidities, and substance use. This increase persisted even among those veterans with an HIV-1 RNA level of less than 500 copies/mL (HR=1.39; 95% CI, 1.17-1.66). The findings were reported in a new study published online Monday in JAMA: Internal Medicine.

Researchers examined the link between HIV infection and risk of AMI among 82,459 participants (97.2% men) in the Veterans Aging Cohort Study Virtual Cohort from April 1, 2003, to December 31, 2009. During that time, 871 AMIs were reported, with the mean number of events per 1000 person-years statistically greater among male veterans with HIV infectioacross three age groups:

· 40 to 49 years: 2.0 vs. 1.5 (P<.05).

· 50 to 59 years: 2.9 vs. 2.2 (P<.05).

· 60 to 69 years: 5.0 vs. 3.3 (P<.05).

The study authors note that while their findings are consistent with prior results in this area, their analyses are more definitive. This study included adjudicated AMI events within the VA, transfers to the VA, events not treated at the VA (Medicare and Medicaid), and fatal and nonfatal AMI events. Also considered in this study were confounders such as smoking and rates of AMI among infected participants compared with uninfected participants matched for demographic and behavioral similarities.

An accompanying editorialist commented that this increased risk found in men underscored “the need for further research in women, research into the underlying mechanisms of the increased risk, and the development of specific interventions to reduce the risk of AMI in HIV-positive populations.”

The article can be accessed for free, here.