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Comparative Study
. 2018 Oct;23(5):467-475.
doi: 10.1177/1358863X18789783. Epub 2018 Aug 13.

Association of HIV infection with age and symptomatic carotid atherosclerotic disease at the time of carotid intervention in the United States

Timothy C Lin  1 , Brittany N Burton  1 , Andrew Barleben  2 , Martin Hoenigl  3   4 , Rodney A Gabriel  5   6
Affiliations
Comparative Study

Association of HIV infection with age and symptomatic carotid atherosclerotic disease at the time of carotid intervention in the United States

Timothy C Lin et al. Vasc Med. 2018 Oct.

Abstract

The primary objectives of this work were: (1) to describe trends in HIV prevalence among those undergoing carotid intervention (carotid endarterectomy or carotid artery stenting) in the United States; and (2) to determine if HIV infection is independently associated with symptomatic carotid atherosclerotic disease or age at the time of carotid intervention. In a nationally representative inpatient database from 2004 to 2014, HIV infection was associated with younger age at the time of carotid intervention (59 years [SE 0.2] vs 71 years [SE 0.01], p < 0.001), male sex (83% vs 58%, p < 0.001), black race (21% vs 4%, p < 0.001), and symptomatic carotid atherosclerotic disease (18.8% vs 11.0%, p < 0.001). Among those undergoing carotid intervention, there was a significant increase in the prevalence of HIV from 0.08% in 2004 to 0.17% in 2014 ( p < 0.001). After adjustment for patient demographics, comorbidities and other covariates, HIV infection remained significantly associated with younger age (-8.9 years; 95% CI: -9.7 to -8.1; p < 0.001) at the time of carotid intervention, but HIV infection was not independently associated with symptomatic carotid atherosclerotic disease.

Keywords: HIV; atherosclerosis; carotid artery disease; endarterectomy; epidemiology; population health; stent.

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Conflict of interest statement

Disclosures: The authors declare that there are no conflicts of interest.

Figures

Figure 1:
Figure 1:. Case selection flowchart from the National Inpatient Sample.
Case numbers are weighted to reflect national projections. CAS, carotid artery stent; CEA, carotid endarterectomy.
Figure 2:
Figure 2:. Relative frequency histogram of age at time of carotid intervention for HIV+ and HIV- admissions.
Figure 3:
Figure 3:. Trends from 2004 through 2014 among HIV-positive (HIV+) and HIV-negative (HIV-) admissions.
Dashed lines are trend lines, error bars represent standard errors, and P-values are for significance of difference between trend slopes as determined from linear or logistic regression mixed-effects models.
See this image and copyright information in PMC

Comment in

References

    1. Gutierrez J, Albuquerque ALA, Falzon L. HIV infection as vascular risk: A systematic review of the literature and meta-analysis. PLoS One 2017; 12: e0176686. - PMC - PubMed
    1. Feinstein MJ, Bahiru E, Achenbach C, et al. Patterns of Cardiovascular Mortality for HIV-Infected Adults in the United States: 1999 to 2013. Am J Cardiol 2016; 117: 214–20. - PMC - PubMed
    1. Mdodo R, Frazier EL, Dube SR, et al. Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys. Ann Intern Med 2015; 162: 335–44. - PubMed
    1. Triant VA, Lee H, Hadigan C, et al. Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab 2007; 92: 2506–12. - PMC - PubMed
    1. Seaberg EC, Muñoz A, Lu M, et al. Association between highly active antiretroviral therapy and hypertension in a large cohort of men followed from 1984 to 2003. AIDS 2005; 19: 953–60. - PubMed

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