Tags

Type your tag names separated by a space and hit enter

Acute coronary syndromes in human immunodeficiency virus patients: a meta-analysis investigating adverse event rates and the role of antiretroviral therapy.
Eur Heart J 2012; 33(7):875-80EH

Abstract

AIMS

Highly active antiretroviral therapy (HAART) dramatically reduces human immunodeficiency virus (HIV)-associated morbidity and mortality, but adverse effects of HAART are becoming an increasing challenge, especially in the setting of acute coronary syndromes (ACS). We thus performed a comprehensive review of studies focusing on ACS in HIV patients.

METHODS AND RESULTS

MEDLINE/PubMed was systematically screened for studies reporting on ACS in HIV patients. Baseline, treatment, and outcome data were appraised and pooled with random-effect methods computing summary estimates [95% confidence intervals (CIs)]. A total of 11 studies including 2442 patients were identified, with a notably low prevalence of diabetes [10.86 (4.11, 17.60); 95% CI]. Rates of in-hospital death were 8.00% (2.8, 12.5; 95% CI), ascribable to cardiovascular events for 7.90% (2.43, 13.37; 95% CI), with 2.31% (0.60, 4.01; 95% CI) developing cardiogenic shock. At a median follow-up of 25.50 months (11.25, 42; 95% CI), no deaths were recorded, with an incidence of 9.42% of acute myocardial infarction (2.68, 16.17; 95% CI) and of 20.18% (9.84, 30.51; 95% CI) of percutaneous coronary revascularization. Moreover, pooled analysis of the studies reporting incidence of acute myocardial infarction in patients exposed to protease inhibitors showed an overall significant risk of 2.68 (odds ratio 1.89, 3.89; 95% CI).

CONCLUSION

Human immunodeficiency virus patients admitted for ACS face a substantial short-term risk of death and a significant long-term risk of coronary revascularization and myocardial infarction, especially if receiving protease inhibitors.

Authors+Show Affiliations

Division of Cardiology, University of Turin, S. Giovanni Battista 'Molinette' Hospital, Corso Bramante 88-90, Turin 10126, Italy. fabrizio.dascenzo@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

22187508

Citation

D'Ascenzo, Fabrizio, et al. "Acute Coronary Syndromes in Human Immunodeficiency Virus Patients: a Meta-analysis Investigating Adverse Event Rates and the Role of Antiretroviral Therapy." European Heart Journal, vol. 33, no. 7, 2012, pp. 875-80.
D'Ascenzo F, Cerrato E, Biondi-Zoccai G, et al. Acute coronary syndromes in human immunodeficiency virus patients: a meta-analysis investigating adverse event rates and the role of antiretroviral therapy. Eur Heart J. 2012;33(7):875-80.
D'Ascenzo, F., Cerrato, E., Biondi-Zoccai, G., Moretti, C., Omedè, P., Sciuto, F., ... Sheiban, I. (2012). Acute coronary syndromes in human immunodeficiency virus patients: a meta-analysis investigating adverse event rates and the role of antiretroviral therapy. European Heart Journal, 33(7), pp. 875-80. doi:10.1093/eurheartj/ehr456.
D'Ascenzo F, et al. Acute Coronary Syndromes in Human Immunodeficiency Virus Patients: a Meta-analysis Investigating Adverse Event Rates and the Role of Antiretroviral Therapy. Eur Heart J. 2012;33(7):875-80. PubMed PMID: 22187508.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute coronary syndromes in human immunodeficiency virus patients: a meta-analysis investigating adverse event rates and the role of antiretroviral therapy. AU - D'Ascenzo,Fabrizio, AU - Cerrato,Enrico, AU - Biondi-Zoccai,Giuseppe, AU - Moretti,Claudio, AU - Omedè,Pierluigi, AU - Sciuto,Filippo, AU - Bollati,Mario, AU - Modena,Maria Grazia, AU - Gaita,Fiorenzo, AU - Sheiban,Imad, Y1 - 2011/12/20/ PY - 2011/12/22/entrez PY - 2011/12/22/pubmed PY - 2012/6/16/medline SP - 875 EP - 80 JF - European heart journal JO - Eur. Heart J. VL - 33 IS - 7 N2 - AIMS: Highly active antiretroviral therapy (HAART) dramatically reduces human immunodeficiency virus (HIV)-associated morbidity and mortality, but adverse effects of HAART are becoming an increasing challenge, especially in the setting of acute coronary syndromes (ACS). We thus performed a comprehensive review of studies focusing on ACS in HIV patients. METHODS AND RESULTS: MEDLINE/PubMed was systematically screened for studies reporting on ACS in HIV patients. Baseline, treatment, and outcome data were appraised and pooled with random-effect methods computing summary estimates [95% confidence intervals (CIs)]. A total of 11 studies including 2442 patients were identified, with a notably low prevalence of diabetes [10.86 (4.11, 17.60); 95% CI]. Rates of in-hospital death were 8.00% (2.8, 12.5; 95% CI), ascribable to cardiovascular events for 7.90% (2.43, 13.37; 95% CI), with 2.31% (0.60, 4.01; 95% CI) developing cardiogenic shock. At a median follow-up of 25.50 months (11.25, 42; 95% CI), no deaths were recorded, with an incidence of 9.42% of acute myocardial infarction (2.68, 16.17; 95% CI) and of 20.18% (9.84, 30.51; 95% CI) of percutaneous coronary revascularization. Moreover, pooled analysis of the studies reporting incidence of acute myocardial infarction in patients exposed to protease inhibitors showed an overall significant risk of 2.68 (odds ratio 1.89, 3.89; 95% CI). CONCLUSION: Human immunodeficiency virus patients admitted for ACS face a substantial short-term risk of death and a significant long-term risk of coronary revascularization and myocardial infarction, especially if receiving protease inhibitors. SN - 1522-9645 UR - https://www.unboundmedicine.com/medline/citation/22187508/full_citation L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehr456 DB - PRIME DP - Unbound Medicine ER -