Myocardial Infarction, Stroke, and Mortality in cART-Treated HIV Patients on Statins

Area of Science:

• Cardiology
• Infectious Diseases
• Pharmacology

Background:

• People living with HIV (PLWH) on combination antiretroviral therapy (cART) experience elevated systemic inflammation and metabolic issues.
• These conditions increase the risk of atherosclerosis and organ damage, potentially manageable with statins.

Purpose of the Study:

• To investigate the association between statin use and the composite outcome of myocardial infarction (MI), stroke, and all-cause mortality in cART-treated PLWH.
• To identify key predictors of cardiovascular events and mortality in this population.

Main Methods:

• Retrospective analysis of 438 PLWH from the Nutrition For Healthy Living (NFHL) cohort.
• Cox proportional hazards regression was used to analyze the association between statins and the composite endpoint.
• Propensity scoring and multiple imputation were employed for confounding control.

Main Results:

• No significant association was found between statin use (history or duration) and the composite endpoint.
• Higher CD4 count, older age, and smoking status were significantly associated with the composite outcome.
• CD4 count remained a significant predictor even when mortality was excluded from the composite outcome.

Conclusions:

• Statin therapy did not demonstrate a significant effect on reducing MI, stroke, or mortality in this cohort of cART-treated PLWH.
• CD4 T-cell count emerged as a crucial independent predictor of adverse cardiovascular outcomes and mortality in PLWH.
• Further research may be needed to explore alternative strategies for cardiovascular risk reduction in PLWH.