Does infection with human immunodeficiency virus have any impact on the cardiovascular outcomes following percutaneous coronary intervention?: a systematic review and meta-analysis

Abstract

BackgroundA direct link between human immunodeficiency virus (HIV)-infected patients and the risk of cardiovascular diseases (CVD) has been shown in recent scientific research. However, this issue is controversial since other previous reports showed no apparent impact of HIV or its anti-retroviral drugs on the cardiovascular system. We aimed to systematically compare the postinterventional adverse cardiovascular outcomes which were observed in patients with and without HIV infection during a mean follow up period ranging from 1 year to 3 years.MethodsCommon electronic databases were searched for studies which compared postinterventional adverse cardiovascular outcomes [mortality, myocardial infarction (MI), cardiac death, target vessel revascularization (TVR), target lesion revascularization (TLR), stroke and major adverse cardiac events (MACEs)] in patients with and without HIV infection. Statistical analysis was carried out by the RevMan 5.3 software whereby Odds Ratios (OR) and 95% Confidence Intervals (CIs) were generated.ResultsTwo thousand two hundred and sixty-eight (2268) patients (821 patients were HIV positive and 1147 patients were HIV negative) were analyzed. The current results showed that mortality was not significantly increased among patients who were HIV positive with OR: 1.13, 95% CI: 0.65–1.96; P = 0.66. Cardiac death was also similarly reported with OR: 1.16, 95% CI: 0.50–2.68; P = 0.74. However, even if recurrent MI, TVR, TLR, MACEs and stroke were higher in patients who were HIV positive, with OR: 1.32, 95% CI: 0.88–2.12; P = 0.18, OR: 1.36, 95% CI: 0.88–2.12; P = 0.17, OR: 1.22, 95% CI: 0.72–2.06; P = 0.46, OR: 1.29, 95% CI: 0.89–1.85; P = 0.17 and OR: 1.47, 95% CI: 0.44–4.89; P = 0.53 respectively, these results were not statistically significant.ConclusionPatients who were infected with HIV had similar mortality post coronary intervention compared to patients who were not infected by the virus, during a mean follow-up period of 1–3 years. In addition, no significant increase in MI, TVR, TLR, MACEs and stroke were observed during this follow up period. Therefore, it might be concluded that no apparent impact of HIV on the cardiovascular outcomes was observed post coronary intervention.

Impact of human immunodeficiency virus (HIV) infection in patients undergoing cardiac surgery: a systematic review

“…As for patients with coronary artery disease, the indication between percutaneous coronary intervention (PCI) or CABG is based on patient's conditions, comorbidities and coronary anatomy. For CABG and PCI, HIV-positive patients exerted similar results to those observed in the general population (Badr et al, 2015;Bundhun et al, 2017;Moran et al, 2020). HIV-status is known to be accompanied by a pro-inflammatory status with increased platelet reactivity (Hauguel-Moreau et al, 2017;Rethy et al, 2020), but this does not seem to directly translate into clinically observable adverse events.…”

“…HIV-status is known to be accompanied by a pro-inflammatory status with increased platelet reactivity (Hauguel-Moreau et al, 2017;Rethy et al, 2020), but this does not seem to directly translate into clinically observable adverse events. A recent metanalysis of 821 HIV-positive and 1147 HIV-negative patients undergoing PCI demonstrated that HIVpositive patients have similar mortality (odds ratio 1.16, 95% confidence interval 0.50-2.68, P = 0.74), no significant increase in recurrent myocardial infarction (odds ratio 1.32, 95% confidence interval 0.88-2.12, P = 0.17), target vessel revascularization (odds ratio 1.22, 95% confidence interval 0.72-2.06, P = 0.46) or major adverse events (odds ratio 1.47, 95% confidence interval 0.44-4.89,P = 0.53) (Bundhun et al, 2017). Those results seem to corroborate the outcomes observed in the CABG scenario.…”

A Systematic Review Exploring the Effect of Human Immunodeficiency Virus on Cardiac Diseases

“…Fifteen studies that met the quality appraisal are included in the systematic review, as discussed in Table 1 [14][15][16][17][18][19][20][21][22][23][24][25][26][27][28].…”

Enfermedad coronaria en el paciente portador del virus de la inmunodeficiencia humana

“…En este grupo, las tasas de trombosis del stent fueron superiores en aquellos con recuento CD4 < 200 cl/mm3 (HR 5.9; IC95% 1,4-2,5; p 0.016) y la ausencia de terapia antirretroviral fue un predictor independiente de muerte cardiovascular (HR 9.9; IC95% 2.1-46; p 0.03). En 2017, un metaanálisis de Bundhun et al 27 incluyó cerca de 2.268 pacientes (821 sero-positivos vs 1447 sero-negativos) sometidos a angioplastía coronaria. No hubo diferencias significativas en términos de mortalidad global, mortalidad cardíaca, Infarto al miocardio recurrente, accidente cerebrovascular isquémico o eventos cardiovasculares mayores al comparar ambos grupos en un seguimiento hasta 3 años.…”