Safety and long-term outcomes after percutaneous coronary intervention in patients with human immunodeficiency virus. [] - 2015

Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006

BACKGROUND: Sparse data exists regarding the risk of patients with HIV who undergo PCI. CONCLUSION: PCI in HIV+ patients is safe, with high procedural success rates, and produces similar outcomes to those seen in HIV- patients at 2 years. HIV+ patients should be treated with DES if possible.Copyright � 2014 Wiley Periodicals, Inc. METHODS: Using a case-control design, we compared baseline characteristics, procedure-related outcomes, in-hospital, and 2-year clinical outcomes of 112 consecutive HIV+ patients versus 112 HIV- controls matched for age, gender, and diabetes mellitus who underwent PCI from April 2003 to September 2011. OBJECTIVE: This study aims to report the long-term outcomes after percutaneous coronary intervention (PCI) in human immunodeficiency virus (HIV+) patients. RESULTS: Baseline characteristics were generally comparable, save for more African Americans and history of chronic renal insufficiency in the HIV+ vs. HIV- group (62.5% vs. 21.4%, P < 0.001) and (27.7% vs. 9.9%, P < 0.001). There was no correlation between CD4 nadir count and extent and diffuseness of coronary artery disease. The occurrence of major adverse cardiac events at 2 years was similar in both groups. Multivariable analysis for independent correlates of major adverse cardiac events at 2 years detected patients with a history of chronic renal insufficiency (OR: 2.44, 95% confidence interval: 1.02-5.83; P = 0.04) and acute myocardial infarction (OR: 2.92, 95% confidence interval: 1.39-6.15; P = 0.005) as correlates for outcome. Post-hoc analysis showed that drug-eluting stent (DES) use in the HIV+ group was beneficial.

1522-1946


*Coronary Artery Disease/th [Therapy]
*HIV Infections/co [Complications]
*Percutaneous Coronary Intervention
Aged
Chi-Square Distribution
Coronary Artery Disease/co [Complications]
Coronary Artery Disease/di [Diagnosis]
Coronary Artery Disease/mo [Mortality]
Databases, Factual
Drug-Eluting Stents
Female
HIV Infections/di [Diagnosis]
HIV Infections/mo [Mortality]
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction/et [Etiology]
Odds Ratio
Patient Selection
Percutaneous Coronary Intervention/ae [Adverse Effects]
Percutaneous Coronary Intervention/is [Instrumentation]
Percutaneous Coronary Intervention/mo [Mortality]
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome


MedStar Heart & Vascular Institute


Journal Article
Observational Study