Types of Myocardial Infarction Among HIV–Infected Individuals

MedicalResearch.com Interview with:
Heidi M. Crane MD, MPH
Associate Professor of Medicine
Associate Director Clinical Epidemiology and Health Services Research Core
Center for AIDS Research
University of Washington

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Studies have suggested that rates of myocardial infarction (MI) are higher in those with HIV, likely for a variety of reasons. However, prior studies have not been able to distinguish MIs by type. The Universal Definition of MI has been recommended by cardiology societies and classifies MIs into types with Type 1 MIs resulting spontaneously from atherosclerotic plaque instability and Type 2 MIs occurring secondary to causes other than atherosclerotic plaque rupture, including hypotension, hypoxia, and stimulant induced spasm resulting in increased oxygen demand or decreased supply. Understanding MI types is likely important as they may indicate a different prognosis and need for different prevention approaches.

MedicalResearch.com: What should readers take away from your report?

Response: Approximately half of MIs among HIV-infected individuals were Type 2, this is much higher than seen in the general population. Type 2 MIs were caused by a variety of clinical conditions such as sepsis and cocaine use. Understanding MI types may help clarify unanswered questions regarding risk factors and prognosis among HIV-infected individuals. Furthermore, these findings have clinical implications as T1MI and T2MI may require different approaches for prevention and treatment.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Relationships between traditional, and HIV-specific cardiovascular risk factors and MI types are complex and will require additional research.

MedicalResearch.com: Is there anything else you would like to add?

Response: No Disclosures

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Crane HM, Paramsothy P, Drozd DR, Nance RM, Delaney JAC, Heckbert SR, Budoff MJ, Burkholder GA, Willig JH, Mugavero MJ, Mathews WC, Crane PK, Moore RD, Eron JJ, Napravnik S, Hunt PW, Geng E, Hsue P, Rodriguez C, Peter I, Barnes GS, McReynolds J, Lober WB, Crothers K, Feinstein M, Grunfeld C, Saag MS, Kitahata MM, for the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) Cohort. Types of Myocardial Infarction Among Human Immunodeficiency Virus–Infected Individuals in the United States. JAMA Cardiol. Published online January 04, 2017. doi:10.1001/jamacardio.2016.5139

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Last Updated on January 5, 2017 by Marie Benz MD FAAD