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Cardiac Catheterization Procedures in Patients with HIV: A Retrospective Analysis
Bertrand Ebner1, Louis Vincent1, Jelani Grant1
1Department of Internal Medicine, Jackson Health System/University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Insights
Cardiac catheterization (CC) in people with HIV (PWH) revealed significant coronary artery disease (CAD). Focus on traditional cardiovascular disease (CVD) risk factors is crucial for PWH management.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Effective antiretroviral therapies have reduced HIV mortality but increased non-AIDS comorbidities like cardiovascular disease (CVD).
- Understanding the utilization and outcomes of cardiac catheterization (CC) in people with HIV (PWH) is essential for managing their cardiovascular health.
Purpose of the Study:
- To investigate the current status and characteristics of cardiac catheterization procedures in people with HIV (PWH).
- To assess the prevalence of coronary artery disease (CAD) and treatment outcomes in PWH undergoing CC.
- To compare traditional cardiovascular risk factors and HIV-specific factors between PWH who underwent CC and those who did not.
Main Methods:
- Retrospective study conducted at a University Hospital in South Florida from 2017 to 2019.
- Analysis of medical records from 985 PWH who underwent cardiac catheterization.
- Comparison of demographic, clinical, and HIV-related data between PWH who had CC and those who did not, controlling for age, sex, and BMI.
Main Results:
- Cardiac catheterization was performed in 1.9% of PWH.
- Obstructive coronary artery disease (CAD) was found in 68% of PWH undergoing CC, with 77% receiving percutaneous coronary intervention (PCI) and 21% undergoing coronary artery bypass grafting (CABG).
- PWH who underwent CC showed higher rates of statin use (63% vs. 25%) and low ejection fraction (38% vs. 11%) compared to those who did not. No significant differences were observed in hypertension, HbA1c, CD4 count, or viral load status.
Conclusions:
- Despite advances in HIV treatment, cardiovascular disease remains a significant concern for people with HIV.
- The study highlights the importance of addressing traditional cardiovascular risk factors in PWH, as HIV-specific factors did not significantly influence the need for cardiac catheterization.
- Optimizing management of traditional CVD risk factors is crucial for improving cardiovascular outcomes in the PWH population.
Abstract:
With the advent of effective antiretroviral therapies, there has been a decrease in HIV-related mortality, but an increase in non-AIDS-related comorbidities including cardiovascular disease (CVD). We sought to investigate current status of cardiac catheterization (CC) procedures in people with HIV (PWH). This is a retrospective study done at a University Hospital in South Florida between 2017 and 2019. Medical records from 985 PWH indicated that CC was performed in 1.9% of the cases. Of the PWH who underwent CC, 68% were found to have obstructive coronary artery disease (CAD). Among obstructive CAD cases, PCI was performed in 77% and CABG in 21% of cases; 26% had a repeat procedure and 11% died from non-cardiac causes. When comparing PWH who had CC to those who did not, there was a significantly higher rate of statin use (63% vs. 25%, p < 0.015) and a higher prevalence of low ejection fraction (38% vs. 11%, p = 0.004) among those patients who underwent CC. However, there was no significant difference in the prevalence of hypertension (p = 0.13), HbA1c levels (p = 0.32), CD4 count (p = 0.45) nor in undetectable viral load status (p = 0.75) after controlling for age, sex and BMI. Despite the finding of traditional CVD risk factors among PWH, there were no differences in HIV-related factors among patients requiring CC, supporting the importance of optimization of traditional CVD risk factors in this population.
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