Sex differences in the contemporary management of HIV patients admitted for acute myocardial infarction

Ogunbayo, Gbolahan; Bidwell, Katrina; Misumida, Naoki; Ha, Le Dung; Abdel‐Latif, Ahmed; Elayi, Claude S.; Smyth, Susan S.; Messerli, Adrian W.

doi:10.1002/clc.22902

Cited by 4 publications

(3 citation statements)

References 41 publications

(88 reference statements)

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“…Ogunbayo et al evaluated sex differences in management of MI in PLWH in a large US‐based cohort [31]. Among those with an acute MI, WLWH were younger (53.1 vs. 54.3), more likely than MLWH to be black (57.2 vs. 36%), to have diabetes (38.5% vs. 24.1%), to be obese (14.1% vs. 5.2%) and to be anaemic (26.7% vs. 16.9%).…”

Section: Resultsmentioning

confidence: 99%

“…Abraham et al [32] noted that the rate of HIV viral suppression was markedly lower in black than in non‐black participants (47% vs. 73%). Ogunbayo et al [31] also found that WLWH, of whom a higher proportion were black compared with the MLWH, were significantly less likely to undergo coronary revascularization following MI. These two studies, both from North America, highlight the need to explore sex and race‐related inequality in the healthcare setting as a barrier to WLWH accessing care.…”

Section: Discussionmentioning

confidence: 99%

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Comorbidities in women living with HIV: A systematic review

2022

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Objectives Effective antiretroviral therapy (ART) has improved the life expectancy of women living with HIV (WLWH). This population is now experiencing age‐related comorbidities. This systematic review presents the current understanding of the prevalence and impact of comorbidities in WLWH in the modern ART era. Methods MEDLINE and Embase were searched for studies (1 January 2010 to 1 September 2020) reporting the prevalence of cardiovascular, bone, renal and neurocognitive disease in WLWH aged > 18 years. Studies were included if at least 100 participants (or > 50%) were female and data analysis included prevalence by sex. Results In all, 3050 articles were identified and screened; 153 full‐text articles were assessed for eligibility and 38 were included in the final review. Significant gaps in the literature were identified, notably a lack of data on WLWH aged > 50 years. The data suggest a high burden of cardiovascular, bone, renal and neurocognitive disease in WLWH compared with HIV negative women. Traditional risk factors, such as hypertension, diabetes and dyslipidaemia, were common and often poorly managed. Generalizability of the results was limited, as many studies were conducted in the USA. Comparisons between WLWH and men with HIV were limited by marked differences in demographic and socioeconomic factors. Conclusions Women living with HIV experience a high burden of comorbid disease. Traditional risk factors are common and often poorly managed. This review also highlights the magnitude of differences between women and men living with HIV beyond the pathophysiological. Future research must unpick the complex drivers of morbidity in WLWH, to improve the holistic management of this population.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comorbidities in women living with HIV: A systematic review

2022

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“…Past studies have reported that women living with HIV have a significantly higher risk of CVD compared to seronegative females, and are less likely to be re-vascularized by PCI [ 23 , 24 , 25 ]. However, in this study, we found a high prevalence of women with HIV that underwent CC (41.2%) and PCI (36.4%).…”

Section: Discussionmentioning

confidence: 99%

Cardiac Catheterization Procedures in Patients with HIV: A Retrospective Analysis

Ebner

Vincent

Grant

et al. 2021

JCDD

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With the advent of effective antiretroviral therapies, there has been a decrease in HIV-related mortality, but an increase in non-AIDS-related comorbidities including cardiovascular disease (CVD). We sought to investigate current status of cardiac catheterization (CC) procedures in people with HIV (PWH). This is a retrospective study done at a University Hospital in South Florida between 2017 and 2019. Medical records from 985 PWH indicated that CC was performed in 1.9% of the cases. Of the PWH who underwent CC, 68% were found to have obstructive coronary artery disease (CAD). Among obstructive CAD cases, PCI was performed in 77% and CABG in 21% of cases; 26% had a repeat procedure and 11% died from non-cardiac causes. When comparing PWH who had CC to those who did not, there was a significantly higher rate of statin use (63% vs. 25%, p < 0.015) and a higher prevalence of low ejection fraction (38% vs. 11%, p = 0.004) among those patients who underwent CC. However, there was no significant difference in the prevalence of hypertension (p = 0.13), HbA1c levels (p = 0.32), CD4 count (p = 0.45) nor in undetectable viral load status (p = 0.75) after controlling for age, sex and BMI. Despite the finding of traditional CVD risk factors among PWH, there were no differences in HIV-related factors among patients requiring CC, supporting the importance of optimization of traditional CVD risk factors in this population.

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