Infection with the human immunodeficiency virus (HIV) was associated with an increased risk of acute myocardial infarction (AMI, heart attack), a new study has found. Due to the successful antiretroviral therapy (ART), people infected with HIV are living longer and are at risk for heart disease, researchers said. Matthew S. Freiberg, M. D., M. Sc., of the University of Pittsburgh School of Medicine, and colleagues examined whether HIV infection was associated with an increased risk of AMI after adjusting for standard Framingham risk factors in a large group of HIV-positive veterans and a similar group of uninfected veterans. Researchers, who analyzed data from 82,459 study participants, found that during a median follow-up of 5.9 years there were 871 AMI events. "Across three decades of age, the mean . AMI events per 1,000 person-years was consistently and significantly higher for HIV-positive compared with uninfected veterans," according to the study results. The results indicate that for veterans ages 40 to 49 years, the events per 1,000 person-years were 2.0 for HIV-positive veterans vs. 1.5 for uninfected veterans; for those ages 50 to 59 years, 3.9 vs. 2.2; and for those ages 60 to 69 years, 5.0 vs. 3.3. After adjusting for Framingham risk factors, co-existing illnesses and substance use, HIV-positive veterans had an increased risk of incident AMI compared with uninfected veterans (hazard ratio, 1.48), according to the results. The study also noted that an "excess risk" remained among those achieving an HIV-1 RNA level less than 500 copies/mL compared with uninfected veterans (hazard ratio, 1.39). Researchers noted that the study''s findings might not be generalizable to women because the group of patients studied was overwhelmingly male. "In conclusion, HIV infection is independently associated with AMI after adjustment for Framingham risk, comorbidities and substance use. Unsuppressed HIV viremia, low CD4 cell count, Framingham risk factors, hepatitis C virus, renal disease and anemia are also associated with AMI," the study concluded. The finding was published Online First by JAMA Internal Medicine, a JAMA Network publication. From ANI
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