Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV
Background Hospitalization with community‐acquired pneumonia (CAP) is associated with an increased risk of cardiovascular disease (CVD) events in patients uninfected with HIV. We evaluated whether people living with HIV (PLWH) have a higher risk of CVD or mortality than individuals uninfected with H...
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| Format: | Article |
| Language: | English |
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Wiley
2020-12-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.017645 |
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| author | Jerry S. Zifodya Meredith S. Duncan Kaku A. So‐Armah Engi F. Attia Kathleen M. Akgün Maria C. Rodriguez‐Barradas Vincent C. Marconi Matthew J. Budoff Roger J. Bedimo Charles W. Alcorn Guy W. Soo Hoo Adeel A. Butt Joon W. Kim Jason J. Sico Hilary A. Tindle Laurence Huang Janet P. Tate Amy C. Justice Matthew S. Freiberg Kristina Crothers |
| author_facet | Jerry S. Zifodya Meredith S. Duncan Kaku A. So‐Armah Engi F. Attia Kathleen M. Akgün Maria C. Rodriguez‐Barradas Vincent C. Marconi Matthew J. Budoff Roger J. Bedimo Charles W. Alcorn Guy W. Soo Hoo Adeel A. Butt Joon W. Kim Jason J. Sico Hilary A. Tindle Laurence Huang Janet P. Tate Amy C. Justice Matthew S. Freiberg Kristina Crothers |
| author_sort | Jerry S. Zifodya |
| collection | DOAJ |
| description | Background Hospitalization with community‐acquired pneumonia (CAP) is associated with an increased risk of cardiovascular disease (CVD) events in patients uninfected with HIV. We evaluated whether people living with HIV (PLWH) have a higher risk of CVD or mortality than individuals uninfected with HIV following hospitalization with CAP. Methods and Results We analyzed data from the Veterans Aging Cohort Study on US veterans admitted with their first episode of CAP from April 2003 through December 2014. We used Cox regression analyses to determine whether HIV status was associated with incident CVD events and mortality from date of admission through 30 days after discharge (30‐day mortality), adjusting for known CVD risk factors. We included 4384 patients (67% [n=2951] PLWH). PLWH admitted with CAP were younger, had less severe CAP, and had fewer CVD risk factors than patients with CAP who were uninfected with HIV. In multivariable‐adjusted analyses, CVD risk was similar in PLWH compared with HIV‐uninfected (hazard ratio [HR], 0.89; 95% CI, 0.70–1.12), but HIV infection was associated with higher mortality risk (HR, 1.49; 95% CI, 1.16–1.90). In models stratified by HIV status, CAP severity was significantly associated with incident CVD and 30‐day mortality in PLWH and patients uninfected with HIV. Conclusions In this study, the risk of CVD events during or after hospitalization for CAP was similar in PLWH and patients uninfected with HIV, after adjusting for known CVD risk factors and CAP severity. HIV infection, however, was associated with increased 30‐day mortality after CAP hospitalization in multivariable‐adjusted models. PLWH should be included in future studies evaluating mechanisms and prevention of CVD events after CAP. |
| first_indexed | 2024-12-13T12:25:20Z |
| format | Article |
| id | doaj.art-baf6e0d6a3b649bbb025ddfa3b93fd9e |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-13T12:25:20Z |
| publishDate | 2020-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-baf6e0d6a3b649bbb025ddfa3b93fd9e2022-12-21T23:46:23ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802020-12-0192310.1161/JAHA.120.017645Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIVJerry S. Zifodya0Meredith S. Duncan1Kaku A. So‐Armah2Engi F. Attia3Kathleen M. Akgün4Maria C. Rodriguez‐Barradas5Vincent C. Marconi6Matthew J. Budoff7Roger J. Bedimo8Charles W. Alcorn9Guy W. Soo Hoo10Adeel A. Butt11Joon W. Kim12Jason J. Sico13Hilary A. Tindle14Laurence Huang15Janet P. Tate16Amy C. Justice17Matthew S. Freiberg18Kristina Crothers19Department of Medicine Section of Pulmonary Diseases, Critical Care, and Environmental Medicine Tulane University School of Medicine New Orleans LADepartment of Medicine Division of Cardiovascular Medicine Vanderbilt University Medical Center Nashville TNSection of General Internal Medicine Boston University School of Medicine Boston MADepartment of Medicine Division of Pulmonary, Critical Care, and Sleep Medicine University of Washington Seattle WADepartment of Medicine Section of Pulmonary, Critical Care and Sleep Medicine Veterans Affairs Connecticut Healthcare System West Haven CTInfectious Diseases Section Michael E. DeBakey Veterans Affairs Medical Center Baylor College of Medicine Houston TXAtlanta Veterans Affairs Medical Center Division of Infectious Diseases Department of Global Health Rollins School of Public Health and Department of Medicine Emory University School of Medicine Atlanta GADepartment of Cardiology Los Angeles Biomedical Research Institute at Harbor‐UCLA Los Angeles CADepartment of Medicine VA North Texas Health Care System and University of Texas Southwestern Medical Center Dallas TXDepartment of Biostatistics Graduate School of Public Health University of Pittsburgh PADepartment of Medicine Pulmonary, Critical Care and Sleep Section Veterans Affairs Greater Los Angeles Healthcare System Los Angeles CAVeterans Affairs Pittsburgh Healthcare System Pittsburgh PACritical Care Medicine James J. Peters Veterans Affairs Medical Center Bronx NYNeurology Service and Clinical Epidemiology Research Center (CERC) Veterans Affairs Connecticut Healthcare System West Haven CTGeriatric Research Education and Clinical Centers (GRECC) Veterans Affairs Tennessee Valley Healthcare System Nashville TNDepartment of Medicine Zuckerberg San Francisco General HospitalUniversity of California San Francisco San Francisco CADepartment of Medicine Section of Pulmonary, Critical Care and Sleep Medicine Veterans Affairs Connecticut Healthcare System West Haven CTYale University School of Medicine New Haven CTDepartment of Medicine Division of Cardiovascular Medicine Vanderbilt University Medical Center Nashville TNDepartment of Medicine Division of Pulmonary, Critical Care, and Sleep Medicine University of Washington Seattle WABackground Hospitalization with community‐acquired pneumonia (CAP) is associated with an increased risk of cardiovascular disease (CVD) events in patients uninfected with HIV. We evaluated whether people living with HIV (PLWH) have a higher risk of CVD or mortality than individuals uninfected with HIV following hospitalization with CAP. Methods and Results We analyzed data from the Veterans Aging Cohort Study on US veterans admitted with their first episode of CAP from April 2003 through December 2014. We used Cox regression analyses to determine whether HIV status was associated with incident CVD events and mortality from date of admission through 30 days after discharge (30‐day mortality), adjusting for known CVD risk factors. We included 4384 patients (67% [n=2951] PLWH). PLWH admitted with CAP were younger, had less severe CAP, and had fewer CVD risk factors than patients with CAP who were uninfected with HIV. In multivariable‐adjusted analyses, CVD risk was similar in PLWH compared with HIV‐uninfected (hazard ratio [HR], 0.89; 95% CI, 0.70–1.12), but HIV infection was associated with higher mortality risk (HR, 1.49; 95% CI, 1.16–1.90). In models stratified by HIV status, CAP severity was significantly associated with incident CVD and 30‐day mortality in PLWH and patients uninfected with HIV. Conclusions In this study, the risk of CVD events during or after hospitalization for CAP was similar in PLWH and patients uninfected with HIV, after adjusting for known CVD risk factors and CAP severity. HIV infection, however, was associated with increased 30‐day mortality after CAP hospitalization in multivariable‐adjusted models. PLWH should be included in future studies evaluating mechanisms and prevention of CVD events after CAP.https://www.ahajournals.org/doi/10.1161/JAHA.120.017645AIDScardiovascular diseasecommunity‐acquired pneumoniaHIV |
| spellingShingle | Jerry S. Zifodya Meredith S. Duncan Kaku A. So‐Armah Engi F. Attia Kathleen M. Akgün Maria C. Rodriguez‐Barradas Vincent C. Marconi Matthew J. Budoff Roger J. Bedimo Charles W. Alcorn Guy W. Soo Hoo Adeel A. Butt Joon W. Kim Jason J. Sico Hilary A. Tindle Laurence Huang Janet P. Tate Amy C. Justice Matthew S. Freiberg Kristina Crothers Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease AIDS cardiovascular disease community‐acquired pneumonia HIV |
| title | Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV |
| title_full | Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV |
| title_fullStr | Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV |
| title_full_unstemmed | Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV |
| title_short | Community‐Acquired Pneumonia and Risk of Cardiovascular Events in People Living With HIV |
| title_sort | community acquired pneumonia and risk of cardiovascular events in people living with hiv |
| topic | AIDS cardiovascular disease community‐acquired pneumonia HIV |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.017645 |
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