Chronic obstructive pulmonary disease and the risk for myocardial infarction by type in people with HIV.
Journal
AIDS (London, England)
ISSN: 1473-5571
Titre abrégé: AIDS
Pays: England
ID NLM: 8710219
Informations de publication
Date de publication:
01 04 2023
01 04 2023
Historique:
pmc-release:
01
04
2024
pubmed:
3
2
2023
medline:
17
3
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
The relationship between chronic obstructive pulmonary disease (COPD) and cardiovascular disease in people with HIV (PWH) is incompletely understood. We determined whether COPD is associated with risk of myocardial infarction (MI) among PWH, and if this differs for type 1 (T1MI) and type 2 (T2MI). We utilized data from five sites in the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort, a multisite observational study. Our primary outcome was an adjudicated MI, classified as T1MI or T2MI. We defined COPD based on a validated algorithm requiring COPD diagnosis codes and at least 90-day continuous supply of inhalers. We conducted time-to-event analyses to first MI and used multivariable Cox proportional hazards models to measure associations between COPD and MI. Among 12 046 PWH, 945 had COPD. Overall, 309 PWH had an MI: 58% had T1MI ( N = 178) and 42% T2MI ( N = 131). In adjusted models, COPD was associated with a significantly increased risk of all MI [adjusted hazard ratio (aHR) 2.68 (95% confidence interval (CI) 1.99-3.60)] even after including self-reported smoking [aHR 2.40 (95% CI 1.76-3.26)]. COPD was also associated with significantly increased risk of T1MI and T2MI individually, and with sepsis and non-sepsis causes of T2MI. Associations were generally minimally changed adjusting for substance use. COPD is associated with a substantially increased risk for MI, including both T1MI and T2MI, among PWH. Given the association with both T1MI and T2MI, diverse mechanistic pathways are involved. Future strategies to decrease risk of T1MI and T2MI in PWH who have COPD are needed.
Identifiants
pubmed: 36728918
doi: 10.1097/QAD.0000000000003465
pii: 00002030-202304010-00005
pmc: PMC10041661
mid: NIHMS1858817
doi:
Types de publication
Observational Study
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
745-752Subventions
Organisme : NHLBI NIH HHS
ID : R01 HL126536
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL126538
Pays : United States
Organisme : NIAID NIH HHS
ID : R24 AI067039
Pays : United States
Organisme : NIA NIH HHS
ID : R56 AG057262
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA044112
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI027757
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI117943
Pays : United States
Organisme : NHLBI NIH HHS
ID : K01 HL137557
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI094189
Pays : United States
Organisme : NIDA NIH HHS
ID : U01 DA036935
Pays : United States
Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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