1. HIV Infection and Long-Term Residual Cardiovascular Risk After Acute Coronary Syndrome
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Franck Boccara, Murielle Mary‐Krause, Valérie Potard, Emmanuel Teiger, Sylvie Lang, Nadjib Hammoudi, Marion Chauvet, Stéphane Ederhy, Laurie Dufour‐Soulat, Yann Ancedy, Pascal Nhan, Saroumadi Adavane, Ph. Gabriel Steg, Christian Funck‐Brentano, Dominique Costagliola, Ariel Cohen, S. Weber, K. Wahbi, P. Beaufils, P. Henri, G. Sideris, D. Thomas, G. Montalescot, F. Beygui, C. Meuleman, S. Janower, F. Raoux, G. Dufaitre, N. Benyounes, P. L. Michel, B. Petillon, N. Hammoudi, P. Gueret, J. L. Dubois‐Rande, E. Teiger, P. Lim, M. Slama, P. Colin, C. Saudubray, O. Dubourg, O. Milleron, B. Gallet, F. Duclos, S. Godard, L. Fuchs, V. Dormagen, P. Lewy, S. Cattan, O. Nallet, G. Grollier, J. Shayne, J. E. Wolf, Y. Cottin, J. Machecourt, H. Bouvaist, G. Finet, B. De Breyne, J. N. Trochu, M. Baudouy, E. Ferrari, M. Benhamou, J. Allal, D. Coisne, H. Le Breton, M. Bedossa, J. Puel, M. Elbaz, L. Larifla, S. Matheron, R. Landman, G. Fremont, G. Spiridon, P. Blanche, J. P. Morini, D. Sicard, V. Zeller, D. Batisse, P. Clevenbergh, G. Cessot, E. Dohin, M. A. Valantin, S. Khelifa, P. M. Girard, F. Lallemand, B. Lefebvre, J. P. Laporte, J. L. Meynard, H. Bideault, O. Picard, M. C. Meyohas, P. Campa, J. Tredup, L. Fonquernie, G. Raguin, J. M. Molina, A. Furco, S. Gharakanian, J. P. Vincensini, J. B. Guiard‐Schmid, G. Pialoux, B. Cardon, A. S. Lascaux, F. Chaix, P. Lesprit, R. Fior, F. Boue, C. Dupont, C. Bellier, A. Blanc, T. Lambert, T. Touahri, G. Force, P. de Truchis, M. A. Compagnucci‐Seguenot, I. Cahitte, L. Roudière, M. E. Techer, P. Thelpin, D. Troisvallets, A. Lepretre, M. Echard, Y. Le Mercier, D. Houlbert, S. Dargere, C. Bazin, R. Verdon, B. De Goer, M. Duong, P. Chavanet, E. Gozlan, P. Leclercq, F. Brunel‐Dal Mas, J. Durant, P. Heudier, C. Brunet‐François, G. Le Moal, J. M. Chapplin, C. Arvieux, G. Chaumentin, B. Guerin, E. Bonnet, Y. Poinsignon, F. Boulard, I. De Lacroix, M. T. Goerger‐Sow, M. Kirstetter, M. Volstein, F. Laylavoix, X. Copin, C. Ceppi, Service de Cardiologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-CHU Saint-Antoine [AP-HP], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Henri Mondor, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Centre d'Investigation Clinique Henri Mondor (CIC Henri Mondor), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut de cardiologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Pitié-Salpêtrière [AP-HP], Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, CIC Paris Est, Service de pharmacologie médicale [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases [IHU ICAN], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Centre d'investigation clinique Paris Est (CIC Paris-Est), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], and Service de Pharmacologie médicale [CHU Pitié-Salpêtrière]
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Male ,Heart disease ,[SDV]Life Sciences [q-bio] ,Human immunodeficiency virus (HIV) ,Aftercare ,heart failure ,HIV Infections ,heart disease ,030204 cardiovascular system & hematology ,medicine.disease_cause ,Coronary artery disease ,0302 clinical medicine ,prevention ,Recurrence ,Risk Factors ,Cardiovascular Disease ,Secondary Prevention ,Medicine ,030212 general & internal medicine ,Longitudinal Studies ,Prospective Studies ,Original Research ,Middle Aged ,Prognosis ,3. Good health ,Editorial ,myocardial infarction ,Anti-Retroviral Agents ,Cardiovascular Diseases ,Cardiology ,Female ,France ,Cardiology and Cardiovascular Medicine ,coronary artery disease ,Adult ,Acute coronary syndrome ,medicine.medical_specialty ,03 medical and health sciences ,Percutaneous Coronary Intervention ,Internal medicine ,Humans ,Acute Coronary Syndrome ,business.industry ,dyslipidemia ,Coronary Care Units ,Editorials ,HIV ,medicine.disease ,HIV infection ,Cerebrovascular Disorders ,Heart Disease Risk Factors ,Case-Control Studies ,ST Elevation Myocardial Infarction ,business ,Dyslipidemia - Abstract
Background It is unclear whether HIV infection affects the long‐term prognosis after an acute coronary syndrome (ACS). The objective of the current study was to compare rates of major adverse cardiac and cerebrovascular events after a first ACS between people living with HIV (PLHIV) and HIV‐uninfected (HIV−) patients, and to identify determinants of cardiovascular prognosis. Methods and Results Consecutive PLHIV and matched HIV− patients with a first episode of ACS were enrolled in 23 coronary intensive care units in France. Patients were matched for age, sex, and ACS type. The primary end point was major adverse cardiac and cerebrovascular events (cardiac death, recurrent ACS, recurrent coronary revascularization, and stroke) at 36‐month follow‐up. A total of 103 PLHIV and 195 HIV− patients (mean age, 49 years [SD, 9 years]; 94.0% men) were included. After a mean of 36.6 months (SD, 6.1 months) of follow‐up, the risk of major adverse cardiac and cerebrovascular events was not statistically significant between PLHIV and HIV− patients (17.8% and 15.1%, P =0.22; multivariable hazard ratio [HR], 1.60; 95% CI, 0.67–3.82 [ P =0.29]). Recurrence of ACS was more frequent among PLHIV (multivariable HR, 6.31; 95% CI, 1.32–30.21 [ P =0.02]). Stratified multivariable Cox models showed that HIV infection was the only independent predictor for ACS recurrence. PLHIV were less likely to stop smoking (47% versus 75%; P =0.01) and had smaller total cholesterol decreases (–22.3 versus –35.0 mg/dL; P =0.04). Conclusions Although the overall risk of major adverse cardiac and cerebrovascular events was not statistically significant between PLHIV and HIV− individuals, PLHIV had a higher rate of recurrent ACS. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00139958.
- Published
- 2020
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