There has been a rising concern about how the status of Human Immunodeficiency Virus (HIV) infection impacts heart health, specifically in the case of Acute Myocardial Infarction (AMI), or heart attacks, that are treated using percutaneous coronary intervention (PCI) – a non-surgical procedure used to treat the narrowed coronary arteries of the heart. This article delves into the details of a study conducted using the National Inpatient Sample Database, scrutinizing the trends during the years 2003 to 2015 to understand any potential correlations.
Initially, the total of 2,191,129 AMI cases included 2,178,995 HIV-negatives and 12,134 HIV-positives, differentiated based on whether patients showed symptoms or not. Of the HIV-positive cases, 7140 were symptomatic and 4994 were asymptomatic. The data revealed a concerning increase in mortality and other severe outcomes for symptomatic HIV-positive patients undergoing PCI treatment.
The symptomatic HIV-positive cases demonstrated over three times the in-hospital mortality rates, as well as significantly higher chances of developing acute kidney injuries and cardiac shocks. On top of this, they were subject to longer duration of hospital stays and underwent more procedures compared to their HIV-negative counterparts. Moreover, these alarming trends were persistent across 2003 to 2015.
The gravity of the situation becomes clearer when we consider that the HIV virus has already accounted for 40.1 million fatalities worldwide, converting from a fatal condition to a chronic one due to advancements in antiretroviral therapy. As a result, it has also led to an increased risk of parallel chronic conditions, primarily cardiovascular diseases. The incidence of HIV-related heart diseases has been increasing steadily, accumulating to 2.6 million disability-adjusted years annually.
A common treatment protocol for AMI is percutaneous coronary intervention (PCI). Some evidences of bias in treating HIV-positive patients with AMI have been remarked. Prior studies indicate that HIV would contribute to greater mortality rates in patients who underwent PCI.
This study was conducted using the National Inpatient Sample (NIS), the largest openly accessible inpatient healthcare database in the US, with an annual weighted estimate of over 35 million admissions. It also differentiates between symptomatic and asymptomatic HIV-positive patients as they have differing implications on the outcomes of infection prevention.
In light of this research, a reassessment of treatment protocols considering the status of HIV infection might be necessary. As the field of Infection Prevention progresses, practitioners need to be alert to these interlinks between HIV infection and other health conditions, adapting their practice accordingly.