In patients with HIV and heart failure (HF), protease inhibitor-based regimens are associated with dyslipidemia, diabetes, coronary artery disease (CAD), a lower left ventricular ejection fraction, and a higher pulmonary artery systolic pressure (PASP). The retrospective single-center study included all 394 antiretroviral therapy-treated persons with human immunodeficiency virus (PHIV) who were hospitalized with HF in 2011, and stratified by PI and non-PI (NPI). The primary outcome was cardiovascular (CV) mortality and secondary outcome was 30-day HF readmission rate. Researchers found:
- Of the 394 PHIV with HF (mean age 60 ±9.5 years, 47% female), 145 (37%) were prescribed a PI, while 249 (63%) were prescribed NPI regimens.
- PHIV who were receiving a PI had higher rates of hyperlipidemia, diabetes mellitus, and CAD; higher PASP; and lower left ventricular ejection fraction.
- In follow-up, PI was associated with increased CV mortality and 30-day HF readmission.
- Overall, PIs were associated with a 2-fold increased risk of CV mortality.
Alvi RM, Neilan AM, Tariq N, et al. Protease inhibitors and cardiovascular outcomes in patients with HIV and heart failure. J Am Coll Cardiol. 2018;72(5):518-530. doi:10.1016/j.jacc.2018.04.083.
This Week's Must Reads
Evolocumab Lowers LDL-C in Patient Subgroups, Clin Cardiol; 2018 Oct 21; Stroes, Robinson, et al
Is Further Lowering of LDL-C in Patients Safe?, JAMA Cardiol; 2018 Sep; Sabatine, Wiviott, et al
Effects of Primary Prevention on CVD Event Risk, J Manag Care Spec Pharm; 2018 Nov; Han, et al
FH Patients with Diabetes at Elevated Risk for CVD, J Clin Lipidol; ePub 2018 Sep 17; Paquette, et al
Long-Term Benefit to Statin Eligibility, JAMA Cardiol; ePub 2018 Oct 24; Thanassoulis, et al
Must Reads in Heart Failure
“Food Deserts” & Hospitalization in Patients with HF, Am J Cardiol; ePub 2018 Oct 18; Morris, et al
Timing of ICD Placement From Last Hospitalization for HF, Circulation; ePub 2018 Sep 13; Ambrosy, et al
Outcomes in Patients with Alcoholic Cardiomyopathy, Clin Cardiol; ePub 2018 Sep 4; Ram, et al
PIs and CV Outcomes in Patients with HIV and HF, J Am Coll Cardiol; 2018 Jul; Alvi, Neilan, et al
Exercise Training Workloads in Patients with HF, Am Heart J; ePub 2018 Jul 10; Keteyian, et al