Risk of Myocardial Infarction in Patients with HIV Infection Exposed to Specific Individual Antiretroviral Drugs from the 3 Major Drug Classes: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study
Identifieur interne : 007065 ( Main/Exploration ); précédent : 007064; suivant : 007066Risk of Myocardial Infarction in Patients with HIV Infection Exposed to Specific Individual Antiretroviral Drugs from the 3 Major Drug Classes: The Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) Study
Auteurs : Signe Westring Worm [Danemark] ; Caroline Sabin [Royaume-Uni] ; Rainer Weber [Suisse] ; Peter Reiss [Pays-Bas] ; Wafaa El-Sadr [États-Unis] ; Francois Dabis ; Stephane De Wit [Belgique] ; Matthew Law [Australie] ; Antonella D'Arminio Monforte [Italie] ; Nina Friis-M Ller [Danemark] ; Ole Kirk [Danemark] ; Eric Fontas [France] ; Ian Weller [Royaume-Uni] ; Andrew Phillips [Danemark] ; Jens Lundgren [Danemark]Source :
- The Journal of Infectious Diseases [ 0022-1899 ] ; 2010-02-01.
Abstract
Background. The risk of myocardial infarction (MI) in patients with human immunodeficiency virus (HIV) infection has been assessed in 13 anti-HIV drugs in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Methods. Poisson regression models were adjusted for cardiovascular risk factors, cohort, calendar year, and use of other antiretroviral drugs and assessed the association between MI risk and cumulative (per year) or recent (current or in the past 6 months) use of antiretroviral drugs, with 130,000 person-years of exposure. Results. Over 178,835 person-years, 580 patients developed MI. There were no associations between use of tenofovir, zalcitabine, zidovudine, stavudine, or lamivudine and MI risk. Recent exposure to abacavir or didanosine was associated with an increased risk of MI. No association was found between MI risk and cumulative exposure to nevirapine, efavirenz, nelfinavir, or saquinavir. Cumulative exposure to indinavir and lopinavir-ritonavir was associated with an increased risk of MI (relative rate [RR] per year, 1.12 and 1.13, respectively). These increased risks were attenuated slightly (RR per year, 1.08 [95% confidence interval {CI}, 1.02–1.14] and 1.09 [95% CI, 1.01–1.17], respectively) after adjustment for lipids but were not altered further after adjustment for other metabolic parameters. Conclusions. Of the drugs considered, only indinavir, lopinavir-ritonavir, didanosine, and abacavir were associated with a significantly increased risk of MI. As with any observational study, our findings must be interpreted with caution (given the potential for confounding) and in the context of the benefits that these drugs provide.
Url:
DOI: 10.1086/649897
Affiliations:
- Australie, Belgique, Danemark, France, Italie, Pays-Bas, Royaume-Uni, Suisse, États-Unis
- Angleterre, Grand Londres, Hollande-Septentrionale, Hovedstaden, Lombardie, Nouvelle-Galles du Sud, Provence-Alpes-Côte d'Azur, Région de Bruxelles-Capitale, État de New York
- Amsterdam, Bruxelles, Copenhague, Londres, Milan, Nice, Sydney
- University College de Londres
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type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">University College de Londres</orgName></affiliation></author><author><name sortKey="Phillips, Andrew" sort="Phillips, Andrew" uniqKey="Phillips A" first="Andrew" last="Phillips">Andrew Phillips</name><affiliation wicri:level="3"><country xml:lang="fr">Danemark</country><wicri:regionArea>Copenhagen HIV Programme, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author><author><name sortKey="Lundgren, Jens" sort="Lundgren, Jens" uniqKey="Lundgren J" first="Jens" last="Lundgren">Jens Lundgren</name><affiliation wicri:level="3"><country xml:lang="fr">Danemark</country><wicri:regionArea>Copenhagen HIV Programme, University of Copenhagen, Copenhagen</wicri:regionArea><placeName><settlement type="city">Copenhague</settlement><region type="région" nuts="2">Hovedstaden</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">The Journal of Infectious Diseases</title><title level="j" type="abbrev">The Journal of Infectious Diseases</title><idno type="ISSN">0022-1899</idno><idno type="eISSN">1537-6613</idno><imprint><publisher>The University of Chicago Press</publisher><date type="published" when="2010-02-01">2010-02-01</date><biblScope unit="volume">201</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="318">318</biblScope><biblScope unit="page" to="330">330</biblScope></imprint><idno type="ISSN">0022-1899</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-1899</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Background. The risk of myocardial infarction (MI) in patients with human immunodeficiency virus (HIV) infection has been assessed in 13 anti-HIV drugs in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Methods. Poisson regression models were adjusted for cardiovascular risk factors, cohort, calendar year, and use of other antiretroviral drugs and assessed the association between MI risk and cumulative (per year) or recent (current or in the past 6 months) use of antiretroviral drugs, with 130,000 person-years of exposure. Results. Over 178,835 person-years, 580 patients developed MI. There were no associations between use of tenofovir, zalcitabine, zidovudine, stavudine, or lamivudine and MI risk. Recent exposure to abacavir or didanosine was associated with an increased risk of MI. No association was found between MI risk and cumulative exposure to nevirapine, efavirenz, nelfinavir, or saquinavir. Cumulative exposure to indinavir and lopinavir-ritonavir was associated with an increased risk of MI (relative rate [RR] per year, 1.12 and 1.13, respectively). These increased risks were attenuated slightly (RR per year, 1.08 [95% confidence interval {CI}, 1.02–1.14] and 1.09 [95% CI, 1.01–1.17], respectively) after adjustment for lipids but were not altered further after adjustment for other metabolic parameters. Conclusions. Of the drugs considered, only indinavir, lopinavir-ritonavir, didanosine, and abacavir were associated with a significantly increased risk of MI. As with any observational study, our findings must be interpreted with caution (given the potential for confounding) and in the context of the benefits that these drugs provide.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Belgique</li><li>Danemark</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Hollande-Septentrionale</li><li>Hovedstaden</li><li>Lombardie</li><li>Nouvelle-Galles du Sud</li><li>Provence-Alpes-Côte d'Azur</li><li>Région de Bruxelles-Capitale</li><li>État de New York</li></region><settlement><li>Amsterdam</li><li>Bruxelles</li><li>Copenhague</li><li>Londres</li><li>Milan</li><li>Nice</li><li>Sydney</li></settlement><orgName><li>University College de Londres</li></orgName></list><tree><noCountry><name sortKey="Dabis, Francois" sort="Dabis, Francois" uniqKey="Dabis F" first="Francois" last="Dabis">Francois Dabis</name></noCountry><country name="Danemark"><region name="Hovedstaden"><name sortKey="Worm, Signe Westring" sort="Worm, Signe Westring" uniqKey="Worm S" first="Signe Westring" last="Worm">Signe Westring Worm</name></region><name sortKey="Friis M Ller, Nina" sort="Friis M Ller, Nina" uniqKey="Friis M Ller N" first="Nina" last="Friis-M Ller">Nina Friis-M Ller</name><name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name><name sortKey="Lundgren, Jens" sort="Lundgren, Jens" uniqKey="Lundgren J" first="Jens" last="Lundgren">Jens Lundgren</name><name sortKey="Phillips, Andrew" sort="Phillips, Andrew" uniqKey="Phillips A" first="Andrew" last="Phillips">Andrew Phillips</name><name sortKey="Worm, Signe Westring" sort="Worm, Signe Westring" uniqKey="Worm S" first="Signe Westring" last="Worm">Signe Westring Worm</name><name sortKey="Worm, Signe Westring" sort="Worm, Signe Westring" uniqKey="Worm S" first="Signe Westring" last="Worm">Signe Westring Worm</name><name sortKey="Worm, Signe Westring" sort="Worm, Signe Westring" uniqKey="Worm S" first="Signe Westring" last="Worm">Signe Westring Worm</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Sabin, Caroline" sort="Sabin, Caroline" uniqKey="Sabin C" first="Caroline" last="Sabin">Caroline Sabin</name></region><name sortKey="Weller, Ian" sort="Weller, Ian" uniqKey="Weller I" first="Ian" last="Weller">Ian Weller</name></country><country name="Suisse"><noRegion><name sortKey="Weber, Rainer" sort="Weber, Rainer" uniqKey="Weber R" first="Rainer" last="Weber">Rainer Weber</name></noRegion></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name></region></country><country name="États-Unis"><region name="État de New York"><name sortKey="El Sadr, Wafaa" sort="El Sadr, Wafaa" uniqKey="El Sadr W" first="Wafaa" last="El-Sadr">Wafaa El-Sadr</name></region></country><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="De Wit, Stephane" sort="De Wit, Stephane" uniqKey="De Wit S" first="Stephane" last="De Wit">Stephane De Wit</name></region></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Law, Matthew" sort="Law, Matthew" uniqKey="Law M" first="Matthew" last="Law">Matthew Law</name></region></country><country name="Italie"><region name="Lombardie"><name sortKey="Monforte, Antonella D Arminio" sort="Monforte, Antonella D Arminio" uniqKey="Monforte A" first="Antonella D'Arminio" last="Monforte">Antonella D'Arminio Monforte</name></region></country><country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Fontas, Eric" sort="Fontas, Eric" uniqKey="Fontas E" first="Eric" last="Fontas">Eric Fontas</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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