Abstract 9198: Clinical characteristics, Presentation and Outcomes of Percutaneous Coronary Intervention among HIV-positive Patients Compared to Controls: A Comprehensive Meta-Analysis of Existing Studies
Introduction: The impact of human immunodeficiency virus infection on the outcomes of patients undergoing percutaneous coronary intervention (PCI) is not well defined. We conducted a meta-analysis of all existing studies comparing the clinical events in HIV (+) patients and controls. Hypothesis: HIV infection and antiretroviral therapy may portend a higher risk for recurrent coronary events after PCI.
Methods: A comprehensive PubMed search identified 6 studies comparing 366 HIV (+) patients and 1021 controls. Angiographic and clinical outcomes (including all-cause mortality, cardiovascular mortality, stent thrombosis, recurrent ACS, repeat revascularization and stroke) were studied. Review Manager 5.1 was used to conduct statistical analysis. Odds ratio (OR) and 95% confidence interval (CI) were calculated using random effects model. A p-value of <0.05 was considered significant.
Results: HIV (+) patients were more likely to be young males with reduced prevalence of DM, HTN and hyperlipidemia. The proportion of smoking and illicit drug use was higher in the HIV (+) group. A higher proportion of HIV (+) patients presented with ST-elevation myocardial infarction prior to PCI compared to controls (38.7% vs. 30.5%; p=0.007). There were no differences in the angiographic characteristics (stent type, stent diameter, stent length, no. of vessels involved). The proportion of individuals undergoing revascularization with angioplasty or stent implantation was similar between HIV and non-HIV groups. Over a mean follow up of 13 months, there was no difference in mortality, stroke, and stent thrombosis. Recurrent ACS was more frequent in HIV (+) patients (OR: 2.67; 95% CI: 1.53-4.67) with a trend towards increased repeat revascularization in HIV (+) patients [Table].
Conclusion: In conclusion, HIV (+) patients are more likely to be readmitted with recurrent ACS after PCI compared to non-HIV patients. HIV status is not associated with increased mortality after PCI.
- © 2012 by American Heart Association, Inc.