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Acute Myocardial Infarction in Rats
Published on: February 16, 2011
Smoking and Type 1 Versus Type 2 Myocardial Infarction Among People With HIV in the United States: Results from the
Heidi M Crane1, Robin M Nance, Stephanie A Ruderman
1Heidi M. Crane, MD, MPH, is a Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Robin M. Nance, PhD, is a Research Scientist, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Stephanie A. Ruderman, PhD, is a Research Scientist, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Lydia N. Drumright, PhD, is an Assistant Professor, Department of Biobehavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, Washington, USA. L. Sarah Mixson, MPH, is a Research Scientist, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Susan R. Heckbert, MD, is a Professor of Epidemiology, Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA. Matthew J. Feinstein, MD, is an Associate Professor of Medicine, Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Matthew J. Budoff, MD, is a Professor of Medicine, Division of Cardiology, Department of Medicine, Lundquist Institute at Harbor-UCLA Medical Center, Torrance, Los Angeles, California, USA. Laura Bamford, MD, is an Associate Clinical Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California, USA. Edward Cachay, MD, is a Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California, USA. Sonia Napravnik, PhD, is an Associate Professor of Epidemiology, Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA. Richard D. Moore, MD, is a Professor of Medicine, Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Massachusetts, USA. Jeanne Keruly, MS, CRNP, is an Assistant Professor of Medicine, Division of Infectious Diseases, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. Amanda L. Willig, PhD, is an Associate Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama, USA. Greer A. Burkholder, MD, is an Associate Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama, USA. Andrew Hahn, MD, is a Clinical Assistant Professor, Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA. Jimmy Ma, MD, is an Acting Instructor, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Rob Fredericksen, PhD, is an Assistant Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Michael S. Saag, MD, is a Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Alabama Birmingham, Birmingham, Alabama, USA. Geetanjali Chander, MD, is a Professor of Medicine, Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA. Mari M. Kitahata, MD, is a Professor of Medicine, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Kristina Crothers, MD, is a Professor of Medicine, Division of Pulmonology, Department of Medicine, University of Washington, Seattle, Washington, USA. Kenneth H. Mayer, MD, is a Professor of Medicine, Fenway Institute, Boston, Massachusetts, USA. Conall O'Cleirigh, PhD, is an Associate Professor in Psychology, Fenway Institute, Boston, Massachusetts, USA. Karen Cropsey, MD, is a Professor of Psychiatry, Department of Psychiatry, University of Alabama Birmingham, Birmingham, Alabama, USA. Bridget M. Whitney, PhD, is a Senior Research Scientist, Division of Infectious Diseases, Department of Medicine, University of Washington, Seattle, Washington, USA. Joseph A.C. Delaney, PhD, is an Associate Professor of Medicine, Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, Washington, USA.
Abstract:
Smoking is a myocardial infarction (MI) risk factor among people with HIV (PWH). Questions persist regarding the role of smoking behaviors and measurements (e.g., intensity, duration) on MI risk. We used Cox proportional hazards regression to compare the association of smoking parameterization with incidents of type 1 and type 2 MI and whether smoking intensity or duration improves MI risk prediction among PWH. Among 11,637 PWH, 37% reported currently smoking, and there were 346 MIs. Current smoking was associated with type 1 (84% increased risk) but not type 2 MI in adjusted analyses. The type 1 MI model with pack years had the best goodness of fit compared with other smoking parameterizations. Ever or never parameterization and smoking diagnosis data had significantly poorer model fit. These results highlight the importance of differentiating MI types and performing patient-based smoking assessments to improve HIV care and research rather than relying on smoking status from diagnoses.
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