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Sudden cardiac death in patients with human immunodeficiency virus infection

Zian H Tseng1, Eric A Secemsky, David Dowdy

  • 1Section of Cardiac Electrophysiology, Division of Cardiology, University of California-San Francisco, San Francisco, CA 94313, USA. zhtseng@medicine.ucsf.edu

Journal of the American College of Cardiology
|May 19, 2012
PubMed

Insights

Sudden cardiac death (SCD) is a significant cause of mortality in patients with human immunodeficiency virus (HIV). This study found SCD rates were 4.5-fold higher in HIV patients, often linked to pre-existing heart conditions.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Cardiovascular disease is a growing concern in the aging human immunodeficiency virus (HIV)-infected population.
  • The incidence and specific characteristics of sudden cardiac death (SCD) in this demographic remain understudied.

Purpose of the Study:

  • To determine the incidence of SCD in patients with HIV.
  • To describe the clinical features associated with SCD in this population.

Main Methods:

  • Retrospective analysis of 2,860 HIV patients from a San Francisco clinic (2000-2009).
  • Deaths and causes were identified using the National Death Index and clinic records.
  • SCD was defined using ICD-10 codes for cardiac death and WHO criteria for circumstances.

Main Results:

  • Of 230 deaths, 30 (13%) were classified as SCD, occurring at a rate 4.5 times higher than expected.
  • SCD patients were older and had a higher prevalence of myocardial infarction, cardiomyopathy, heart failure, and arrhythmias compared to other causes of death.
  • SCD accounted for 86% of all cardiac deaths in the cohort.

Conclusions:

  • Sudden cardiac death (SCD) represents a major cause of cardiac and non-AIDS related natural deaths among individuals with HIV.
  • Further research is necessary to elucidate the mechanisms driving SCD in this population, potentially involving inflammation, treatment interruptions, or drug interactions.
Abstract

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