Document Detail


Acute coronary syndromes in human immunodeficiency virus patients: a meta-analysis investigating adverse event rates and the role of antiretroviral therapy.
MedLine Citation:
PMID:  22187508     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Highly active antiretroviral therapy (HAART) dramatically reduces human immunodeficiency virus (HIV)-associated morbidity and mortality, but adverse effects of HAART are becoming an increasing challenge, especially in the setting of acute coronary syndromes (ACS). We thus performed a comprehensive review of studies focusing on ACS in HIV patients.
METHODS AND RESULTS: MEDLINE/PubMed was systematically screened for studies reporting on ACS in HIV patients. Baseline, treatment, and outcome data were appraised and pooled with random-effect methods computing summary estimates [95% confidence intervals (CIs)]. A total of 11 studies including 2442 patients were identified, with a notably low prevalence of diabetes [10.86 (4.11, 17.60); 95% CI]. Rates of in-hospital death were 8.00% (2.8, 12.5; 95% CI), ascribable to cardiovascular events for 7.90% (2.43, 13.37; 95% CI), with 2.31% (0.60, 4.01; 95% CI) developing cardiogenic shock. At a median follow-up of 25.50 months (11.25, 42; 95% CI), no deaths were recorded, with an incidence of 9.42% of acute myocardial infarction (2.68, 16.17; 95% CI) and of 20.18% (9.84, 30.51; 95% CI) of percutaneous coronary revascularization. Moreover, pooled analysis of the studies reporting incidence of acute myocardial infarction in patients exposed to protease inhibitors showed an overall significant risk of 2.68 (odds ratio 1.89, 3.89; 95% CI).
CONCLUSION: Human immunodeficiency virus patients admitted for ACS face a substantial short-term risk of death and a significant long-term risk of coronary revascularization and myocardial infarction, especially if receiving protease inhibitors.
Authors:
Fabrizio D'Ascenzo; Enrico Cerrato; Giuseppe Biondi-Zoccai; Claudio Moretti; Pierluigi Omedè; Filippo Sciuto; Mario Bollati; Maria Grazia Modena; Fiorenzo Gaita; Imad Sheiban
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2011-12-20
Journal Detail:
Title:  European heart journal     Volume:  33     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-04-04     Completed Date:  2012-06-15     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  875-80     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University of Turin, S. Giovanni Battista 'Molinette' Hospital, Corso Bramante 88-90, Turin 10126, Italy. fabrizio.dascenzo@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / chemically induced*
Angioplasty, Balloon, Coronary / statistics & numerical data
Anti-HIV Agents / adverse effects*
Epidemiologic Methods
Female
HIV Infections / drug therapy*
HIV Protease Inhibitors / adverse effects
Humans
Male
Middle Aged
Myocardial Infarction / chemically induced
Prognosis
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/HIV Protease Inhibitors
Comments/Corrections
Comment In:
Eur Heart J. 2012 Apr;33(7):813-5   [PMID:  22108832 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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