Key result
Older age linked to ~7% higher odds of cardiac catheterization per year in HIV.
Why the study?
Effective antiretroviral therapies have reduced HIV-related mortality while increasing cardiovascular disease, prompting investigation into the current status of cardiac catheterization procedures in people with HIV.
What is the prevalence of cardiac catheterization and how do cardiovascular and HIV-related risk factors compare between people with HIV who undergo cardiac catheterization versus those who do not?
Cross-Sectional (n=985)
No
What is the prevalence of cardiac catheterization and how do cardiovascular and HIV-related risk factors compare between people with HIV who undergo cardiac catheterization versus those who do not?
In people with well-controlled HIV, need for cardiac catheterization is driven by aging and traditional cardiovascular risk factors rather than HIV-specific markers, underscoring the need for aggressive primary and secondary cardiovascular risk optimization in this population.
Answers are grounded in this paper and cite their sources.
Traditional risks predominate for catheterization in HIV; leaves open HIV marker roles in prospective CAD cohorts.
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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Ebner et al. (2021) conducted a cross-sectional in HIV infection (People with HIV, PWH) (n=985). Cardiac catheterization (CC) vs. People with HIV who did not undergo cardiac catheterization was evaluated on Undergoing cardiac catheterization (CC) and associated predictors (specifically age per year) (OR 1.069, p=0.003). Cardiac catheterization was performed in 1.9% of patients with HIV (68% showing obstructive CAD), with older age (OR 1.069, p=0.003) and traditional cardiovascular risk factors rather than HIV-specific markers associated with the procedure.
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