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- Title
Coronary revascularization for acute myocardial infarction in the HIV population.
- Authors
Singh, Vikas; Mendirichaga, Rodrigo; Savani, Ghanshyambhai T.; Rodriguez, Alexis P.; Dabas, Nitika; Munagala, Anish; Alfonso, Carlos E.; Cohen, Mauricio G.; Elmariah, Sammy; Palacios, Igor F.
- Abstract
<bold>Objective: </bold>To analyze trends in management and outcomes of patients infected with the human immunodeficiency virus (HIV) undergoing percutaneous coronary intervention (PCI) for an acute myocardial infarction (AMI) in the United States.<bold>Background: </bold>Infection with HIV is an independent risk factor for accelerated atherosclerosis associated with higher rates of AMI. Current trends and outcomes of HIV-infected individuals presenting with AMI in the United States remain unknown.<bold>Methods: </bold>Using the Healthcare Cost and Utilization Project National Inpatient Sample database we identified HIV-infected individuals who underwent PCI for an AMI from 2002 to 2013. Multivariable logistic regression and propensity-score matching were performed to analyze outcomes.<bold>Results: </bold>We identified a total of 59 194 patients of which 7841 underwent PCI during index hospitalization (13.3%). Most patients were men (71%), ≥50 years of age (82%), and white (74%). ST-elevation myocardial infarction was present in 21% of cases. Charlson comorbidity index (CCI) was 5.67 ± 0.4. Predictors of post-procedural complications included female sex, black race, higher CCI, and placement of a bare metal stent, whereas predictors of mortality included occurrence of a complication, ST-elevation myocardial infarction, age ≥70 years, and higher CCI. Conversely, placement of a drug-eluting stent was associated with a reduced risk of complications and mortality. After propensity-score matching, HIV-infected individuals were less likely to undergo PCI and receive a drug-eluting stent, while having longer length of stay, higher hospitalization costs, and higher in-hospital mortality when compared to non-infected individuals.<bold>Conclusion: </bold>Significant disparities continue to affect HIV-infected individuals undergoing PCI for AMI in the United States.
- Subjects
UNITED States; REVASCULARIZATION (Surgery); HIV; MYOCARDIAL infarction treatment; PERCUTANEOUS coronary intervention; MEDICAL care costs
- Publication
Journal of Interventional Cardiology, 2017, Vol 30, Issue 5, p405
- ISSN
0896-4327
- Publication type
journal article
- DOI
10.1111/joic.12433