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Safety and long‐term outcomes after percutaneous coronary intervention in patients with human immunodeficiency virus
Author(s) -
Badr Salem,
Minha Sa'ar,
Kitabata Hironori,
Fatemi Omid,
Torguson Rebecca,
Suddath William O.,
Satler Lowell F.,
Pichard Augusto D.,
Waksman Ron
Publication year - 2014
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25466
Subject(s) - medicine , percutaneous coronary intervention , conventional pci , myocardial infarction , confidence interval , coronary artery disease , diabetes mellitus , cardiology , adverse effect , surgery , endocrinology
Objective This study aims to report the long‐term outcomes after percutaneous coronary intervention (PCI) in human immunodeficiency virus (HIV+) patients. Background Sparse data exists regarding the risk of patients with HIV who undergo PCI. Methods Using a case‐control design, we compared baseline characteristics, procedure‐related outcomes, in‐hospital, and 2‐year clinical outcomes of 112 consecutive HIV+ patients versus 112 HIV‐ controls matched for age, gender, and diabetes mellitus who underwent PCI from April 2003 to September 2011. Results Baseline characteristics were generally comparable, save for more African Americans and history of chronic renal insufficiency in the HIV+ vs. HIV‐ group (62.5% vs. 21.4%, P < 0.001) and (27.7% vs. 9.9%, P < 0.001). There was no correlation between CD4 nadir count and extent and diffuseness of coronary artery disease. The occurrence of major adverse cardiac events at 2 years was similar in both groups. Multivariable analysis for independent correlates of major adverse cardiac events at 2 years detected patients with a history of chronic renal insufficiency (OR: 2.44, 95% confidence interval: 1.02–5.83; P = 0.04) and acute myocardial infarction (OR: 2.92, 95% confidence interval: 1.39–6.15; P = 0.005) as correlates for outcome. Post‐hoc analysis showed that drug‐eluting stent (DES) use in the HIV+ group was beneficial. Conclusion PCI in HIV+ patients is safe, with high procedural success rates, and produces similar outcomes to those seen in HIV‐ patients at 2 years. HIV+ patients should be treated with DES if possible. © 2014 Wiley Periodicals, Inc.