Observational Study

. 2020 Sep;9(17):e017578.

doi: 10.1161/JAHA.119.017578. Epub 2020 Aug 26.

HIV Infection and Long-Term Residual Cardiovascular Risk After Acute Coronary Syndrome

Franck Boccara^{1

2}, Murielle Mary-Krause³, Valérie Potard³, Emmanuel Teiger^{4

5}, Sylvie Lang¹, Nadjib Hammoudi⁶, Marion Chauvet¹, Stéphane Ederhy¹, Laurie Dufour-Soulat¹, Yann Ancedy¹, Pascal Nhan¹, Saroumadi Adavane¹, Ph Gabriel Steg⁷, Christian Funck-Brentano⁸, Dominique Costagliola³, Ariel Cohen¹; PACS‐HIV (Prognosis of Acute Coronary Syndrome in HIV‐Infected Patients) Investigators †

Collaborators, Affiliations

Collaborators

PACS‐HIV (Prognosis of Acute Coronary Syndrome in HIV‐Infected Patients) Investigators †:
S Weber, K Wahbi, P Beaufils, P Henri, G Sideris, D Thomas, G Montalescot, F Beygui, C Meuleman, S Janower, F Raoux, G Dufaitre, N Benyounes, P L Michel, B Petillon, N Hammoudi, P Gueret, J L Dubois-Rande, E Teiger, P Lim, M Slama, P Colin, C Saudubray, O Dubourg, O Milleron, B Gallet, F Duclos, S Godard, L Fuchs, V Dormagen, P Lewy, S Cattan, O Nallet, G Grollier, J Shayne, J E Wolf, Y Cottin, J Machecourt, H Bouvaist, G Finet, B De Breyne, J N Trochu, M Baudouy, E Ferrari, M Benhamou, J Allal, D Coisne, H Le Breton, M Bedossa, J Puel, M Elbaz, L Larifla, S Matheron, R Landman, G Fremont, G Spiridon, P Blanche, J P Morini, D Sicard, V Zeller, D Batisse, P Clevenbergh, G Cessot, E Dohin, M A Valantin, S Khelifa, P M Girard, F Lallemand, B Lefebvre, J P Laporte, J L Meynard, H Bideault, O Picard, M C Meyohas, P Campa, J Tredup, L Fonquernie, G Raguin, J M Molina, A Furco, S Gharakanian, J P Vincensini, J B Guiard-Schmid, G Pialoux, B Cardon, A S Lascaux, F Chaix, P Lesprit, R Fior, F Boue, C Dupont, C Bellier, A Blanc, T Lambert, T Touahri, G Force, P de Truchis, M A Compagnucci-Seguenot, I Cahitte, L Roudière, M E Techer, P Thelpin, D Troisvallets, A Lepretre, M Echard, Y Le Mercier, D Houlbert, S Dargere, C Bazin, R Verdon, B De Goer, M Duong, P Chavanet, E Gozlan, P Leclercq, F Brunel-Dal Mas, J Durant, P Heudier, C Brunet-François, G Le Moal, J M Chapplin, C Arvieux, G Chaumentin, B Guerin, E Bonnet, Y Poinsignon, F Boulard, I De Lacroix, M T Goerger-Sow, M Kirstetter, M Volstein, F Laylavoix, X Copin, C Ceppi

Affiliations

¹ Department of Cardiology Faculty of Medicine AP-HP Hôpitaux de l'Est Parisien Hôpital Saint-Antoine Sorbonne Université Paris France.
² National Institute of Health and Medical Research INSERM UMR_S 938 Sorbonne Université Paris France.
³ INSERM Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP) Sorbonne Université Paris France.
⁴ Interventional Cardiology Unit Henri Mondor University Hospital Assistance Publique Hôpitaux de Paris Créteil France.
⁵ Inserm CIC 1430 et U955 Team 3 Henri Mondor University Hospital Créteil France.
⁶ Inserm UMRS 1166 Institute of Cardiometabolism and Nutrition (ICAN) ACTION Study Group and Institute of Cardiology (AP-HP) Hôpital Pitié-Salpêtrière Sorbonne Université Paris France.
⁷ Département Hospitalo-Universitaire (DHU) Fibrose Inflammation Remodelage (FIRE) INSERM U-1148 University Paris Diderot Assistance Publique - Hôpitaux de Paris (AP-HP) Paris France.
⁸ Department of Pharmacology INSERM CIC Paris-Est, AP-HP ICAN Pitié-Salpêtrière Hospital Sorbonne Université Paris France.

PMID: 32844734
PMCID: PMC7660787
DOI: 10.1161/JAHA.119.017578

Observational Study

HIV Infection and Long-Term Residual Cardiovascular Risk After Acute Coronary Syndrome

Franck Boccara et al. J Am Heart Assoc. 2020 Sep.

. 2020 Sep;9(17):e017578.

doi: 10.1161/JAHA.119.017578. Epub 2020 Aug 26.

Authors

Collaborators

PACS‐HIV (Prognosis of Acute Coronary Syndrome in HIV‐Infected Patients) Investigators †:
S Weber, K Wahbi, P Beaufils, P Henri, G Sideris, D Thomas, G Montalescot, F Beygui, C Meuleman, S Janower, F Raoux, G Dufaitre, N Benyounes, P L Michel, B Petillon, N Hammoudi, P Gueret, J L Dubois-Rande, E Teiger, P Lim, M Slama, P Colin, C Saudubray, O Dubourg, O Milleron, B Gallet, F Duclos, S Godard, L Fuchs, V Dormagen, P Lewy, S Cattan, O Nallet, G Grollier, J Shayne, J E Wolf, Y Cottin, J Machecourt, H Bouvaist, G Finet, B De Breyne, J N Trochu, M Baudouy, E Ferrari, M Benhamou, J Allal, D Coisne, H Le Breton, M Bedossa, J Puel, M Elbaz, L Larifla, S Matheron, R Landman, G Fremont, G Spiridon, P Blanche, J P Morini, D Sicard, V Zeller, D Batisse, P Clevenbergh, G Cessot, E Dohin, M A Valantin, S Khelifa, P M Girard, F Lallemand, B Lefebvre, J P Laporte, J L Meynard, H Bideault, O Picard, M C Meyohas, P Campa, J Tredup, L Fonquernie, G Raguin, J M Molina, A Furco, S Gharakanian, J P Vincensini, J B Guiard-Schmid, G Pialoux, B Cardon, A S Lascaux, F Chaix, P Lesprit, R Fior, F Boue, C Dupont, C Bellier, A Blanc, T Lambert, T Touahri, G Force, P de Truchis, M A Compagnucci-Seguenot, I Cahitte, L Roudière, M E Techer, P Thelpin, D Troisvallets, A Lepretre, M Echard, Y Le Mercier, D Houlbert, S Dargere, C Bazin, R Verdon, B De Goer, M Duong, P Chavanet, E Gozlan, P Leclercq, F Brunel-Dal Mas, J Durant, P Heudier, C Brunet-François, G Le Moal, J M Chapplin, C Arvieux, G Chaumentin, B Guerin, E Bonnet, Y Poinsignon, F Boulard, I De Lacroix, M T Goerger-Sow, M Kirstetter, M Volstein, F Laylavoix, X Copin, C Ceppi

Affiliations

¹ Department of Cardiology Faculty of Medicine AP-HP Hôpitaux de l'Est Parisien Hôpital Saint-Antoine Sorbonne Université Paris France.
² National Institute of Health and Medical Research INSERM UMR_S 938 Sorbonne Université Paris France.
³ INSERM Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP) Sorbonne Université Paris France.
⁴ Interventional Cardiology Unit Henri Mondor University Hospital Assistance Publique Hôpitaux de Paris Créteil France.
⁵ Inserm CIC 1430 et U955 Team 3 Henri Mondor University Hospital Créteil France.
⁶ Inserm UMRS 1166 Institute of Cardiometabolism and Nutrition (ICAN) ACTION Study Group and Institute of Cardiology (AP-HP) Hôpital Pitié-Salpêtrière Sorbonne Université Paris France.
⁷ Département Hospitalo-Universitaire (DHU) Fibrose Inflammation Remodelage (FIRE) INSERM U-1148 University Paris Diderot Assistance Publique - Hôpitaux de Paris (AP-HP) Paris France.
⁸ Department of Pharmacology INSERM CIC Paris-Est, AP-HP ICAN Pitié-Salpêtrière Hospital Sorbonne Université Paris France.

PMID: 32844734
PMCID: PMC7660787
DOI: 10.1161/JAHA.119.017578

Abstract

Background It is unclear whether HIV infection affects the long-term prognosis after an acute coronary syndrome (ACS). The objective of the current study was to compare rates of major adverse cardiac and cerebrovascular events after a first ACS between people living with HIV (PLHIV) and HIV-uninfected (HIV-) patients, and to identify determinants of cardiovascular prognosis. Methods and Results Consecutive PLHIV and matched HIV- patients with a first episode of ACS were enrolled in 23 coronary intensive care units in France. Patients were matched for age, sex, and ACS type. The primary end point was major adverse cardiac and cerebrovascular events (cardiac death, recurrent ACS, recurrent coronary revascularization, and stroke) at 36-month follow-up. A total of 103 PLHIV and 195 HIV- patients (mean age, 49 years [SD, 9 years]; 94.0% men) were included. After a mean of 36.6 months (SD, 6.1 months) of follow-up, the risk of major adverse cardiac and cerebrovascular events was not statistically significant between PLHIV and HIV- patients (17.8% and 15.1%, P=0.22; multivariable hazard ratio [HR], 1.60; 95% CI, 0.67-3.82 [P=0.29]). Recurrence of ACS was more frequent among PLHIV (multivariable HR, 6.31; 95% CI, 1.32-30.21 [P=0.02]). Stratified multivariable Cox models showed that HIV infection was the only independent predictor for ACS recurrence. PLHIV were less likely to stop smoking (47% versus 75%; P=0.01) and had smaller total cholesterol decreases (-22.3 versus -35.0 mg/dL; P=0.04). Conclusions Although the overall risk of major adverse cardiac and cerebrovascular events was not statistically significant between PLHIV and HIV- individuals, PLHIV had a higher rate of recurrent ACS. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT00139958.

Keywords: HIV; acute coronary syndrome; coronary artery disease; dyslipidemia; heart disease.

PubMed Disclaimer

Conflict of interest statement

Dr Boccara reports research grants from Amgen; lecture fees from Janssen, Gilead, ViiV Healthcare, Amgen, Sanofi, MSD, and Servier outside the submitted work. Dr Costagliola reports HIV grants from Janssen and MSD France; personal fees from Janssen, MSD France, and Gilead for lectures; personal fees from Innavirvax, and Merck Switzerland for consultancy, outside the submitted work. Dr Hammoudi reports research grants to the Institution or consulting/lecture fees from Philips, Bayer, Laboratoires Servier, Novartis Pharma, Astra Zeneca, Bristol Myers Squibb, MSD, Fédération Française de Cardiologie, and ICAN outside the submitted work. Dr Steg reports research grants from Bayer, Merck, Sanofi, and Servier; speaking or consulting fees from Amarin, Amgen, AstraZeneca, Bayer/Janssen, Boehringer Ingelheim, Bristol‐Myers Squibb, Lilly, Merck, Novartis, Novo Nordisk, Pfizer, Regeneron, Sanofi, and Servier, Dr Cohen reports a research grant from RESICARD, and consultant/advisory board fees from Amgen, AstraZeneca, Bayer, Bristol‐Myers Squibb, Boehringer Ingelheim, Novartis, and Pfizer. The remaining authors have no disclosures to report.

Figures

**Figure 1. Kaplan–Meier plots by HIV status.**
A, Major adverse cardiac and cerebrovascular events (MACCE). B, Cardiovascular death. C, Recurrent coronary revascularization. D, Stroke. E, Recurrent acute coronary syndrome (ACS). HR indicates hazard ratio; and PLHIV, people living with HIV.

**Figure 2. Kaplan–Meier plots by HIV status.**
A, Target lesion revascularization (TLR). B, Target vessel revascularization (TVR). C, Target vessel failure (TVF). HR indicates hazard ratio; and PLHIV, people living with HIV.

See this image and copyright information in PMC

Comment in

Secondary Prevention of Myocardial Infarction in People Living With HIV Infection.
Erqou S, Rodriguez-Barradas MC. Erqou S, et al. J Am Heart Assoc. 2020 Sep;9(17):e018140. doi: 10.1161/JAHA.120.018140. Epub 2020 Aug 26. J Am Heart Assoc. 2020. PMID: 32844727 Free PMC article. No abstract available.

References

1. Feinstein MJ, Hsue PY, Benjamin LA, Bloomfield GS, Currier JS, Freiberg MS, Grinspoon SK, Levin J, Longenecker CT, Post WS. Characteristics, prevention, and management of cardiovascular disease in people living with HIV: a scientific statement from the American Heart Association. Circulation. 2019;e98–e124. - PMC - PubMed
1. Boccara F, Lang S, Meuleman C, Ederhy S, Mary‐Krause M, Costagliola D, Capeau J, Cohen A. HIV and coronary heart disease: time for a better understanding. J Am Coll Cardiol. 2013;511–523. - PubMed
1. Rotger M, Glass TR, Junier T, Lundgren J, Neaton JD, Poloni ES, van 't Wout AB, Lubomirov R, Colombo S, Martinez R, et al.; MAGNIFICENT Consortium; INSIGHT; Swiss HIV Cohort Study . Contribution of genetic background, traditional risk factors, and HIV‐related factors to coronary artery disease events in HIV‐positive persons. Clin Infect Dis. 2013;112–121. - PMC - PubMed
1. Vachiat A, McCutcheon K, Tsabedze N, Zachariah D, Manga P. HIV and ischemic heart disease. J Am Coll Cardiol. 2017;73–82. - PubMed
1. Rosenson RS, Hubbard D, Monda KL, Reading SR, Chen L, Dluzniewski PJ, Burkholder GA, Muntner P, Colantonio LD. Excess risk for atherosclerotic cardiovascular outcomes among US adults with HIV in the current era. J Am Heart Assoc. 2020;e013744 DOI: 10.1161/JAHA.119.013744 - DOI - PMC - PubMed

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HIV Infection and Long-Term Residual Cardiovascular Risk After Acute Coronary Syndrome

Collaborators

Affiliations

HIV Infection and Long-Term Residual Cardiovascular Risk After Acute Coronary Syndrome

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

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Comment in

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