Types of Myocardial Infarction in People With HIV in Switzerland

Area of Science:

• Cardiology
• Infectious Diseases
• Epidemiology

Background:

• Myocardial infarctions (MIs) in people with human immunodeficiency virus (HIV) are a significant concern.
• Previous North American studies reported approximately 50% of MIs in people with HIV (PWH) as type 2 MI (T2MI).
• Data on the proportions of type 1 MI (T1MI) and T2MI in European PWH were previously unknown.

Purpose of the Study:

• To determine the proportions of T1MI and T2MI in PWH in Switzerland.
• To analyze trends in MI incidence over time within this population.
• To explore associations between T1MI and T2MI and specific biomarkers and genetic risk scores.

Main Methods:

• Retrospective review of medical records for validated MIs in the Swiss HIV Cohort Study (2000-2021).
• Differentiation between T1MI and T2MI.
• Analysis of MI time trends and associations with leukocyte count and coronary artery disease polygenic risk scores (metaGRS, GPSmult).

Main Results:

• Out of 379 validated MIs in 16,027 participants, 94.7% were T1MI and 5.3% were T2MI.
• No significant increasing or decreasing incidence trends were observed for T1MI or T2MI over the study period.
• Higher leukocyte counts and polygenic risk scores were associated with increased odds of T1MI, but associations with T2MI were limited by statistical power.

Conclusions:

• The proportion of T2MI among PWH in Switzerland is approximately 5%, aligning with general population data.
• This rate is lower than previously reported in North American PWH cohorts.
• Findings suggest potential differences in MI etiology or classification between different PWH populations.