Related Experiment Video
Updated: Feb 14, 2026
Induction of Myocardial Infarction in Adult Zebrafish Using Cryoinjury
Published on: April 18, 2012
Recent Abacavir Use Increases Risk of Type 1 and Type 2 Myocardial Infarctions Among Adults With HIV
Richard A Elion1,2, Keri N Althoff3, Jinbing Zhang3
1Department of Medicine, George Washington University School of Medicine, Washington, DC.
Insights
Recent abacavir (ABC) use is linked to myocardial infarction (MI) in adults with HIV. This association holds for both type 1 (T1MI) and type 2 (T2MI) events, suggesting increased cardiovascular risk.
Area of Science:
- Cardiology
- Infectious Diseases
- Pharmacology
Background:
- Persistent confusion exists regarding abacavir (ABC) and myocardial infarction (MI) risk in adults with HIV.
- The potential differential risk between type 1 (T1MI) and type 2 (T2MI) myocardial infarctions associated with ABC use requires clarification.
Purpose of the Study:
- To investigate the association between abacavir (ABC) use and the risk of myocardial infarction (MI) in adults living with HIV.
- To determine if the risk of MI differs based on the type of MI (T1MI vs. T2MI) in the context of ABC use.
Main Methods:
- Utilized discrete time marginal structural models to analyze incident MIs in the North American Cohort Collaboration on Research and Design (2001-2013).
- Addressed channeling biases and time-dependent confounding to estimate hazard ratios (HR) and adjusted hazard ratios (aHR) for T1MI and T2MI separately.
- Conducted a sensitivity analysis to assess if Framingham risk score (FRS) modifies the effect of ABC on MI occurrence.
Main Results:
- The study included 8,265 adults, contributing 29,077 person-years and documenting 123 MI events (65 T1MI, 58 T2MI).
- Recent ABC use (within 6 months) was associated with a significantly increased risk of combined MI outcomes (aHR = 1.84), persisting for both T1MI (aHR = 1.62) and T2MI (aHR = 2.11).
- Framingham risk score (FRS) did not modify the effect of ABC on MI, and its inclusion in the model did not diminish the observed association.
Conclusions:
- Recent abacavir (ABC) use is associated with an increased risk of myocardial infarction (MI) in adults with HIV, independent of known risk factors and FRS.
- Screening for traditional T1MI risk factors may not adequately identify all individuals at risk for ABC-associated MIs, highlighting a need for broader risk assessment.
Background:
There is persistent confusion as to whether abacavir (ABC) increases the risk of myocardial infarction (MI), and whether such risk differs by type 1 (T1MI) or 2 (T2MI) MI in adults with HIV.
Methods:
Incident MIs in North American Cohort Collaboration on Research and Design participants were identified from 2001 to 2013. Discrete time marginal structural models addressed channeling biases and time-dependent confounding to estimate crude hazard ratio (HR) and adjusted hazard ratio (aHR) and 95% confidence intervals; analyses were performed for T1MI and T2MI separately. A sensitivity analysis evaluated whether Framingham risk score (FRS) modified the effect of ABC on MI occurrence.
Results:
Eight thousand two hundred sixty-five adults who initiated antiretroviral therapy contributed 29,077 person-years and 123 MI events (65 T1MI and 58 T2MI). Median follow-up time was 2.9 (interquartile range 1.4-5.1) years. ABC initiators were more likely to have a history of injection drug use, hepatitis C virus infection, hypertension, diabetes, impaired kidney function, hyperlipidemia, low (<200 cells/mm) CD4 counts, and a history of AIDS. The risk of the combined MI outcome was greater for persons who used ABC in the previous 6 months [aHR = 1.84 (1.17-2.91)]; and persisted for T1MI (aHR = 1.62 [1.01]) and T2MI [aHR = 2.11 (1.08-4.29)]. FRS did not modify the effect of ABC on MI (P = 0.14) and inclusion of FRS in the MSM did not diminish the effect of recent ABC use on the combined outcome.
Conclusions:
Recent ABC use was associated with MI after adjustment for known risk factors and for FRS. However, screening for T1MI risks may not identify all or even most persons at risk of ABC use-associated MIs.
Related Concept Videos
01:22Diabetes Mellitus: Type 2 and Gestational
02:13Types of Hormones
01:23Types of RNA
Three main types of RNA are involved in protein synthesis: messenger RNA (mRNA), transfer RNA (tRNA), and ribosomal RNA (rRNA). These RNAs perform diverse functions and can be broadly classified as protein-coding or non-coding RNA. Non-coding RNAs play important roles in the regulation of gene expression in response to developmental and environmental changes. Non-coding RNAs in prokaryotes can be manipulated to develop more effective antibacterial drugs for human or animal use.
RNA...
01:46Types of Selection
01:09Types of Skewness
For instance, in the middle of a pandemic, the geographical distribution of vaccine coverage may be positively skewed towards populations in the global north countries. However,...
01:20Types of Damping