Abstract 6015: Percutaneous Coronary Intervention in Human Immunodeficiency Virus Infection
Background: Human immunodeficiency virus (HIV) patients who undergo percutaneous coronary intervention (PCI) have a substantial risk of recurrent cardiac events. Outcome data in HIV patients who receive drug-eluting stents (DES) are limited. We hypothesized that HIV patients who undergo PCI with DES have less recurrent cardiac events compared with HIV patients with bare metal stents (BMS).
Methods: We evaluated 94 consecutive HIV patients and 94 age- and sex-matched non-HIV patients who underwent PCI with stents between January 2000 and July 2007. Clinical, laboratory, and angiographic data were obtained by chart review. Major adverse cardiovascular events (MACE), defined as cardiovascular death, nonfatal myocardial infarction, and coronary revascularization, were adjudicated by two independent physicians, and Kaplan-Meier survival analysis was performed.
Results: Of the 94 HIV patients, 53 had DES and 41 had BMS. Of the 94 control patients, 45 had DES and 49 had BMS. HIV patients had lower rates of diabetes, hypertension, prior coronary artery disease, and aspirin use compared with non-HIV patients. HIV patients with DES had higher number of stents (2.1 vs. 1.7, 1.4, 1.4; p<0.001) and longer stent length (46 mm vs. 32, 24, 24 mm; p<0.001) than non-HIV-DES, HIV-BMS, and non-HIV-BMS patients, respectively. During a mean follow-up of 2.4 years, DES was associated with lower MACE rate than BMS regardless of HIV status. (Figure⇓)
Conclusions: DES is associated with a lower MACE rate compared with BMS regardless of HIV status. These data suggest that DES should be used in the HIV population.