A-11 | Temporal Trends and Outcomes in HIV Patients Following Acute Myocardial Infarction. A Propensity-Matched Nationwide Analysis

The data on the association between HIV status and outcomes following acute myocardial infarction (AMI) remains limited. The objective of this study was to evaluate the contemporary temporal trends, in-hospital outcomes and predictors of mortality among people living with HIV (PLWH). We analyzed data from the National Inpatient Sample database, from 2016 to 2019, to identify AMI hospitalizations in PLWH and non-HIV populations. Temporal trends and outcomes following AMI were assessed, with propensity score matching (PSM) employed to compare outcomes between groups. Among 4,321,174 AMI hospitalizations, 10,740 were PLWH. The prevalence of PLWH among AMI remained stable over the study period (p-value for trend = 0.12), as did the trend of in-hospital mortality among PLWH (p-value for trend = 0.72). PSM analysis revealed that PLWH had higher odds of in-hospital mortality (OR:1.30, 95% CI: 1.07-1.59, p=0.009), acute kidney injury (AKI) (OR:1.28 95% CI: 1.13-1.45, p<0.001) and AKI requiring dialysis (OR:1.41, 95% CI: 1.18-1.69, p<0.001). Multivariate logistic regression identified predictors of increased in-hospital mortality in PLWH as age ≥65 years, female gender, ST-elevation myocardial infarction (STEMI), coagulopathy, fluid disorders, neurological disorders, liver disease, and cardiac arrhythmias. Our study highlights that despite stable admission rates for AMI, PLWH face higher in-hospital mortality and complications such as AKI. The identified predictors of mortality emphasize the need for individualized management strategies in this population.