Symptomatic human immunodeficiency virus infection is associated with advanced presentation and perioperative mortality in patients undergoing surgery for peripheral arterial disease

Tran, Lan Mai; Cong, Guangzhi; Eslami, Mohammad H.; Mailliard, Robbie B.; Sachdev, Ulka

doi:10.1016/j.jvs.2021.09.034

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…19 The current study is novel as it investigates long-term outcomes following endovascular intervention for PAD among PLWH, and includes procedures performed both in inpatient and outpatient settings. Previous work has demonstrated that PLWH with PAD have an increased risk of perioperative mortality following open surgical revascularization, as well as a higher risk of subsequent amputation, 20 but have not investigated longitudinal outcomes following a percutaneous approach. Data on in-hospital outcomes immediately following PVI among PLWH in the National Inpatient Sample did not demonstrate increased rates of in-hospital amputation or mortality, but did not explore events after discharge.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal outcomes following peripheral vascular intervention among older persons living with HIV

Kentoffio,

Sun,

et al. 2023

Vasc Med

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Background: Persons living with human immunodeficiency virus (HIV, PLWH) have an increased risk of peripheral artery disease (PAD) in comparison to the general population. However, a gap remains in understanding optimal management for this condition. This study assesses longitudinal outcomes associated with peripheral endovascular intervention (PVI) for PAD among PLWH. Methods: All Medicare fee-for-service patients undergoing femoropopliteal artery PVI between April 1, 2015 and December 31, 2018 were identified and stratified by HIV serostatus. The primary outcome was major adverse limb events (MALE), defined as major amputation or arterial embolism/thrombosis following an index procedure. The subdistribution hazard was used to evaluate the association between HIV serostatus and MALE, accounting for the competing risk of death. Results were adjusted for sociodemographics and major comorbidities. Results: Of 168,553 patients who underwent PVI, 357 (0.21%) were PLWH. The average age was 77.0 ± 7.6 years; 80.3% had hypertension, 70.3% had hyperlipidemia, and 24.6% had tobacco use disorder. Compared to those without HIV, PLWH were younger and had a higher burden of cardiovascular risk factors. MALE were substantially more frequent among PLWH, with a cumulative incidence of 24.6%, compared to 14.5% among those without HIV. The adjusted subdistribution hazard ratio was 1.26 (95% CI 1.00–1.58, p = 0.05). The use of guideline-directed statin therapy was low in both groups in the 90 days following revascularization (57.9% in PLWH vs 58.1% in those without HIV, p = 0.95). Conclusion: Among US Medicare beneficiaries, PLWH had poorer long-term outcomes following PVI. Greater attention to the management of symptomatic PAD is warranted for the HIV population, particularly following revascularization.

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Section: Discussionmentioning

confidence: 99%

Longitudinal outcomes following peripheral vascular intervention among older persons living with HIV

Kentoffio,

Sun,

et al. 2023

Vasc Med

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“…We also discovered that symptomatic HIV infection is associated with worse in-hospital outcomes in patients with a pre-existing peripheral arterial disease requiring vascular intervention [9] . Therefore, in this study, we sought to investigate the impact of symptomatic HIV infection on in-hospital outcomes and temporal trends among patients undergoing PCI by the national representative National Inpatient Sample (NIS) 2003-2015.…”

Section: Introductionmentioning

confidence: 88%

Symptomatic HIV infection and in-hospital outcomes in acute myocardial infarction undergoing percutaneous coronary intervention: an insight of national inpatients sample

Ming-zhi

Zhang

et al. 2023

Preprint

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HIV infection increases the risk of acute myocardial infarction (AMI). However, little is known about its effect on in-hospital outcomes and temporal trends in AMI patients undergoing percutaneous coronary intervention (PCI). We queried AMI patients who underwent PCI from the National Inpatient Sample Database (2003–2015) and stratified into three groups: symptomatic, asymptomatic, and HIV-negative. After 1:2 case-control matching (CCM), logistic regression analysis was conducted to determine how HIV infection affected in-hospital outcomes, and we also evaluatedtheir recent trends from 2003-2015. A total weighted national estimate of 2,191,129 AMI cases included 2,178,995 HIV/AIDS-negative cases, 4,994 asymptomatic HIV cases, and 7,140 symptomatic HIV cases. Symptomatic but not asymptomatic HIV patients endured an over tripled in-hospital mortality (aOR 3.84, 95% CI 2.63-5.62), over two-fold of the acute kidney injury (aOR 1.90, 95% CI 1.42–2.54) and the cardiac shock risk (aOR 1.83, 95% CI 1.24-2.70), a longer length of hospital stay (beta 1.27, 95% CI 1.04-1.51), and had more procedures (beta 1.30, 95% CI 1.16-1.44). These disparities related to symptomatic HIV infection lasted from 2003 to 2015. In AMI patients who underwent PCI procedures, symptomatic HIV infection is associated with higher in-hospital mortality and severe outcomes.

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“…According to the WHO, the four clinical stages of HIV infection are acute HIV infection, asymptomatic HIV infection, symptomatic HIV infection, and AIDS 14 . This diagnosis can be accurately identified using the ICD code 15 . Overall, we identified the weighted records of 2,191,129 patients with AMI who underwent PCI procedures after excluding records of patients younger than 18 or with missing data or concurrent AIDS-defining diseases during admission.…”

Section: Methodsmentioning

confidence: 99%

“…We have previously reported that symptomatic HIV infection was associated with worse in-hospital outcomes in patients with a pre-existing peripheral arterial disease requiring vascular intervention 9 . Therefore, in this study, we sought to investigate the impact of symptomatic HIV infection on in-hospital outcomes and temporal trends among patients undergoing PCI using the nationally representative National Inpatient Sample (NIS) from 2003 to 2015.…”

mentioning

confidence: 99%

Symptomatic HIV infection and in-hospital outcomes for patients with acute myocardial infarction undergoing percutaneous coronary intervention from national inpatient sample

Cui,

Qi,

Zhang

et al. 2024

Sci Rep

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Human immunodeficiency virus (HIV) infection increases the risk of acute myocardial infarction (AMI). However, little is known about its association with in-hospital outcomes and temporal trends in patients with AMI undergoing percutaneous coronary intervention (PCI). We queried patients with AMI who underwent PCI from the National Inpatient Sample Database (2003–2015) and stratified them into three groups: symptomatic, asymptomatic, and HIV-negative. After 1:2 case–control matching (CCM), logistic regression analysis was conducted to determine how HIV infection affected in-hospital outcomes. We also evaluated their recent trends from 2003 to 2015. The total weighted national estimate of 2,191,129 AMI cases included 2,178,995 HIV/AIDS-negative, 4994 asymptomatic, and 7140 symptomatic HIV cases. Symptomatic but not asymptomatic patients with HIV suffered more than triple the in-hospital mortality (adjusted odds ratio (aOR) 3.6, 95% confidence interval (CI) 2.5–5.2), over one-fold incidence of acute kidney injury (aOR 2.6 95% CI 1.9–3.4) and cardiogenic shock risk (aOR 1.9, 95% CI 1.3–2.7), a longer length of hospital stay (beta 1.2, 95% CI 1.0–1.5), and had more procedures (beta 1.3, 95% CI 1.2–1.5). These disparities relating to symptomatic HIV infection persisted from 2003 to 2015. In patients with AMI who underwent PCI, symptomatic HIV infection was associated with higher in-hospital mortality and more severe outcomes.

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Symptomatic human immunodeficiency virus infection is associated with advanced presentation and perioperative mortality in patients undergoing surgery for peripheral arterial disease

Cited by 5 publications

References 34 publications

Longitudinal outcomes following peripheral vascular intervention among older persons living with HIV

Longitudinal outcomes following peripheral vascular intervention among older persons living with HIV

Symptomatic HIV infection and in-hospital outcomes in acute myocardial infarction undergoing percutaneous coronary intervention: an insight of national inpatients sample

Symptomatic HIV infection and in-hospital outcomes for patients with acute myocardial infarction undergoing percutaneous coronary intervention from national inpatient sample

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