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Abstract 10613: Symptomatic Human Immunodeficiency Virus Infected Patients Receive Less Aggressive Revascularization Management After Acute Coronary Syndrome, a 5-year Nationwide Analysis.
Circulation 2019; 140(Suppl_1):A10613Circ

Abstract

Introduction: Cardiovascular disease is a leading cause of morbidity and mortality in human immunodeficiency virus (HIV) infected adults, and should be managed more aggressively.Prior studies highlighted treatment disparities for Acute Coronary Syndrome (ACS) among HIV patients. This study aims at examining these disparities with the latest large cohort data. Hypothesis: HIV patient with ACS are as likely to receive cardiac revascularization related procedures compared to control group.

Methods:

We reviewed the Nationwide Inpatient Sample from 2013 to 2016 to identify patients with diagnosis of ACS (ST-elevation and non ST-elevation myocardial infarction, and unstable angina) to compare rates of cardiac procedures (Catheterization, Percutaneous Coronary Intervention - PCI - and Coronary Artery Bypass Graft - CABG) among groups of population of interest (control, asymptomatic HIV, symptomatic HIV).

Results:

Overall, 515,016 patients with primary diagnosis of ACS where identified and among them 2066 (0.40%) of ACS patients had diagnosis of HIV (asymptomatic and symptomatic). Multivariate regression analysis showed statistically significant lower procedural rates for catheterization (OR: 0.62, 95% CI: [0.52, 0.73]), PCI (OR: 0.80, 95% CI: [0.67, 0.96]) and CABG (OR: 0.70, 95% CI: [0.52, 0.93]) in symptomatic HIV compared to control group. For asymptomatic HIV patient group, no significant change of procedural rates were found compared to control group for catheterization, PCI and CABG (respectively OR: 0.90, 95% CI: [0.78, 1.05], OR: 1.13, 95% CI: [1.00, 1.26] and OR: OR: 0.87, 95% CI: [0.72, 1.04]).

Conclusions:

Analysis shows a treatment disparity for ACS for symptomatic HIV patients only as symptomatic HIV affected patients received less aggressive catheterization and revascularization management after ACS, compared to control group. However, this effect was not present for the asymptomatic HIV patient group.

Authors+Show Affiliations

Internal Medicine, Mount Sinai St Luke's-West Hosp, NYC, NY.Mount Sinai St Luke's-West Hosp, New York, NY.Internal Medicine, Mount Sinai St. Luke's-West Hosp, New York, NY.Mount Sinai St. Luke's-West, New York, NY.Mount Sinai St Luke's-West Hosp, New York, NY.Mount Sinai St Luke's-West Hosp, New York, NY.Mount Sinai St Luke's-West Hosp, New York, NY.Cardiology, Mount Sinai St Luke's-West Hosp, New York, NY.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31633997

Citation

Huang Lucas, Claire, et al. "Abstract 10613: Symptomatic Human Immunodeficiency Virus Infected Patients Receive Less Aggressive Revascularization Management After Acute Coronary Syndrome, a 5-year Nationwide Analysis." Circulation, vol. 140, no. Suppl_1, 2019, pp. A10613.
Huang Lucas C, Wu L, Yue B, et al. Abstract 10613: Symptomatic Human Immunodeficiency Virus Infected Patients Receive Less Aggressive Revascularization Management After Acute Coronary Syndrome, a 5-year Nationwide Analysis. Circulation. 2019;140(Suppl_1):A10613.
Huang Lucas, C., Wu, L., Yue, B., Bachoo, N., Abed, R., Berookhim, J., ... Herzog, E. (2019). Abstract 10613: Symptomatic Human Immunodeficiency Virus Infected Patients Receive Less Aggressive Revascularization Management After Acute Coronary Syndrome, a 5-year Nationwide Analysis. Circulation, 140(Suppl_1), pp. A10613. doi:10.1161/circ.140.suppl_1.10613.
Huang Lucas C, et al. Abstract 10613: Symptomatic Human Immunodeficiency Virus Infected Patients Receive Less Aggressive Revascularization Management After Acute Coronary Syndrome, a 5-year Nationwide Analysis. Circulation. 2019 Nov 19;140(Suppl_1):A10613. PubMed PMID: 31633997.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Abstract 10613: Symptomatic Human Immunodeficiency Virus Infected Patients Receive Less Aggressive Revascularization Management After Acute Coronary Syndrome, a 5-year Nationwide Analysis. AU - Huang Lucas,Claire, AU - Wu,Lingling, AU - Yue,Bing, AU - Bachoo,Nikhil, AU - Abed,Robert, AU - Berookhim,Joshua, AU - Wei,Xin, AU - Herzog,Eyal, Y1 - 2019/10/21/ PY - 2019/10/22/entrez PY - 2019/10/22/pubmed PY - 2019/10/22/medline KW - Acquired immunodeficiency syndrome KW - Acute coronary syndromes KW - Coronary artery bypass grafting (CABG) KW - Percutaneous coronary intervention (PCI) SP - A10613 EP - A10613 JF - Circulation JO - Circulation VL - 140 IS - Suppl_1 N2 - Introduction: Cardiovascular disease is a leading cause of morbidity and mortality in human immunodeficiency virus (HIV) infected adults, and should be managed more aggressively.Prior studies highlighted treatment disparities for Acute Coronary Syndrome (ACS) among HIV patients. This study aims at examining these disparities with the latest large cohort data. Hypothesis: HIV patient with ACS are as likely to receive cardiac revascularization related procedures compared to control group. Methods: We reviewed the Nationwide Inpatient Sample from 2013 to 2016 to identify patients with diagnosis of ACS (ST-elevation and non ST-elevation myocardial infarction, and unstable angina) to compare rates of cardiac procedures (Catheterization, Percutaneous Coronary Intervention - PCI - and Coronary Artery Bypass Graft - CABG) among groups of population of interest (control, asymptomatic HIV, symptomatic HIV). Results: Overall, 515,016 patients with primary diagnosis of ACS where identified and among them 2066 (0.40%) of ACS patients had diagnosis of HIV (asymptomatic and symptomatic). Multivariate regression analysis showed statistically significant lower procedural rates for catheterization (OR: 0.62, 95% CI: [0.52, 0.73]), PCI (OR: 0.80, 95% CI: [0.67, 0.96]) and CABG (OR: 0.70, 95% CI: [0.52, 0.93]) in symptomatic HIV compared to control group. For asymptomatic HIV patient group, no significant change of procedural rates were found compared to control group for catheterization, PCI and CABG (respectively OR: 0.90, 95% CI: [0.78, 1.05], OR: 1.13, 95% CI: [1.00, 1.26] and OR: OR: 0.87, 95% CI: [0.72, 1.04]). Conclusions: Analysis shows a treatment disparity for ACS for symptomatic HIV patients only as symptomatic HIV affected patients received less aggressive catheterization and revascularization management after ACS, compared to control group. However, this effect was not present for the asymptomatic HIV patient group. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/31633997/Abstract_10613:_Symptomatic_Human_Immunodeficiency_Virus_Infected_Patients_Receive_Less_Aggressive_Revascularization_Management_After_Acute_Coronary_Syndrome,_a_5-year_Nationwide_Analysis L2 - http://www.ahajournals.org/doi/full/10.1161/circ.140.suppl_1.10613?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -