Outcomes after Acute Myocardial Infarction in HIV-Infected Patients: Analysis of Data from a French Nationwide Hospital Medical Information Database
Background—We aim to assess in-hospital case fatality and 1 year prognosis in HIV-infected patients with AMI.
Methods and Results—From the PMSI database, data from 277,303 consecutive AMI patients hospitalized from 1st January 2005 to 31st December 2009 were analysed. Surviving patients were followed for one year after discharge. HIV-infected patients were compared with those in uninfected patients. Among the cohort, HIV-infected patients (n=608) accounted for 0.22%. All-cause hospital and 1-Y mortality were lower in the HIV-infected group than in uninfected patients (3.1 vs. 8.1 %, respectively, p <0.001 and 1.4% vs. 5.5%, p<0.001). From the database, we then analysed a cohort derived from a matching procedure, with one HIV patient matched with two patients without HIV, based on age and sex (n=1824). Ischemic cardiomyopathy was more frequent in the HIV group (7.6% vs. 4.2%, p=0.003). Hospital and 1-Y mortality were similar in the two groups (3.1 vs. 2.1%, p=0.168 and 1.4 vs. 1.7%, p=0.642, respectively). However, at 12 months, hospitalisation for episodes of heart failure were significantly more frequent in HIV-infected than in uninfected patients, (3.3 vs. 1.4%, respectively p=0.020). HIV infection, diabetes, history of ischemic cardiomyopathy and undergoing PCI, were associated, in univariate analysis, to occurrence of heart failure. By multivariable analysis, HIV infection (OR [95%CI]: 2.82 [1.32-6.01]), diabetes and undergoing PCI remained independent predictors of heart failure.
Conclusions—The present study demonstrated that after AMI, although the short-term risk in HIV patients is comparable to that in uninfected patients, HIV status influences long-term risk.
- Received February 6, 2013.
- Accepted March 21, 2013.