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Table 1 Recent retrospective and prospective studies evaluating the epidemiology of cardiovascular diseases in HIV positive patients

From: What happens to cardiovascular system behind the undetectable level of HIV viremia?

Author, year [Ref.] Cohort Type of study Population Time of follow up Aims Results
Tseng et al. [96] HIV+ patients enrolled in a public HIV Clinic in San Francisco in 10 years Retrospective 2860 HIV+ 3.7 years To determine the incidence of SCD in HIV+ patients Of 230 deaths, 13 % met SCD criteria
SCDs accounted for 86 % of all cardiac deaths (30 of 35)
Mean SCD rate: 2.6 per 1000 person-years (95 % CI 1.8–3.8), 4.5-fold higher than expected
Esser et al. [97] HIV+ outpatients (ClinicalTrials.gov NCT01119729) Prospective observational 803 HIV+ N/A To elucidate CVD prevalence in HIV+ outpatients by standardized non-invasive CV screening Prevalence of CVD: 10.1 % (95 % CI 8.0–12.2 %)
Aging HIV-infected patients (≥45 years) exhibited significantly increased rates of CVD,
 CAD (7.5 vs. 1.8 %, p < 0.001)
 MI (6.0 vs. 1.8 %, p = 0.002)
 PAD (4.6 vs. 1.5 %, p < 0.017)
Significantly associated with the prevalence of CVD in multivariate analyses:
 Age (OR 2.05 xd, 95 % CI 1.64–2.56)
 Smoking (OR 5.96 xd, 95 % CI 2.31–15.38)
 Advanced symptomatic HIV infection (OR 2.60 xd, 95 % CI 1.31–5.15)
Freiberg et al. [8] Veterans aging cohort study virtual cohort (VACS-VC) Prospective observational 55,109 HIV+
27,350 HIV−
5.9 years To investigate whether HIV is associated with an increased risk of MI The mean MI events per 1000 person-years significantly higher (p < 0.05 for all) for HIV-positive compared with uninfected veterans:
 Age 40–49 years, 2.0 (1.6–2.4) vs. 1.5 (1.3–1.7)
 Age 50–59 years, 3.9 (3.3–4.5) vs. 2.2 (1.9–2.5)
 Age 60–69 years, 5.0 (3.8–6.7) vs. 3.3 (2.6–4.2)
After adjusting for Framingham risk factors, comorbidities, and substance use, HIV-positive veterans had an increased risk of inc ident MI compared with uninfected veterans (hazard ratio, 1.48; 95 % CI, 1.27–1.72)
Silverberg et al. [9] Kaiser Permanente California Retrospective 22,081 HIV+ 
230,069 HIV−
13 years To evaluate association of HIV infection and immunedeficiency on MI risk MI incidence rate per 100,000 person-years: 283 for HIV+ subjects [RR of 1.4 (95 % CI 1.3–1.6)]
Nadir CD4: associated with MIs (RR per 100 cells = 0.88; 95 % CI 0.81–0.96)
Recent CD4, HIV-RNA, prior ART use, duration of PI and NNRTI: not associated with MIs
Esser et al. [98] HIV HEART (HIVH) study Prospective observational 1481 HIV+ 7,5 years To assess the frequency and clinical course of CVE in HIV+ patents by standardized non-invasive CV screening  Advanced clinical and immunological stages:
 Significantly (p < 0.001) associated with higher incidences of CVE (A 17.7 %; B 33.1 %; C 49.2 % and I 3.1 %; II 32.3 %; III 64.6 %)
 No associated with the duration of HIV-infection (per year: HR: 0.91 [0.88–0.94]) and ART (per year: HR: 0.81 [0.79–0.84])
Petoumenos et al. [99] Data collection on adverse events of anti-HIV Drugs (D:A:D)  Retrospective 24,323 HIV+ men N/A To statistically model the relative increased risk of MI, CAD and CVD per year older Crude MI, CAD and CVD event rates per 1000 person-years increased from 2.29, 3.11 and 3.65 in those aged 40–45 years to 6.53, 11.91 and 15.89 in those aged 60–65 years, respectively
Carballo et al. [100] Acute myocardial infarction in Switzerland (AMIS) registry plus Swiss HIV cohort study (SHCS) (aggregated data) Retrospective Patients who survived an incident MI occurring on or after 1/1/2005: 133 HIV+,
5328 HIV−
1 year To determine whether HIV infection is a risk factor for worse outcomes in patients who survived an incident MI: HIV infection associated with a significantly increased risk of all-cause mortality 1 year after incident MI
No significant differences in recurrent MI (4 [3.0 %] HIV+ and 146 [3.0 %] HIV− individuals, or 1.16, 95 % CI 0.41–3.27)
Klein et al. [10] Kaiser Permanente California Retrospective 24,768 HIV+
257,600 HIV−
15 years To evaluate changes of MI risk from 1996 to 2011 by HIV status The adjusted MI RR for HIV status declined from 1.8 in 1996–1999 to 1.0 in 2010–2011
  1. CAD coronary artery disease, CI confidence interval, CV cardiovascular, CVD cardiovascular diseases, CVE cardiovascular event, xd per decade, HR Hazard ratio, MI myocardial infarction, N/A not applicable, NNRTI non-nucleoside reverse transcriptase inhibitors, OR odds ratio, PAD peripheral arterial diseases, PI protease inhibitors, RR rate ratio, SCD sudden cardiac death