HIV status and type of coronary stent placed in patients presenting with ST-elevation myocardial infarction

Aiham Albaeni, Che' Harris, Shaker M Eid, Marwan S. Abougergi, Scott Wright

Research output: Contribution to journalArticle

Abstract

Background Drug-eluting stents (DES) outperform bare-metal stents (BMS) in reducing target vessel revascularization following a percutaneous coronary intervention (PCI). Little is known about the types of stents placed in HIV-positive patients presenting with ST-segment elevation myocardial infarctions (STEMIs). Methods We used the 2003-2013 National Inpatient Sample to identify adults of 18 years or older presenting with STEMI. We evaluated differences in stent type placed following STEMIs on the basis of HIV status. Temporal trends in the use of PCI, DES, and BMS were studied on the basis of HIV status. Results Of 1 695 947 patients with STEMI, 5887 (0.3%) were HIV-positive patients. Following STEMIs, HIV-positive patients were equally likely to have PCI compared with HIV-negative patients [adjusted odds ratio (AOR): 1.04, 95% confidence interval (CI): 0.89-1.21, P=0.63]. However, HIV-positive patients were less likely to have DES (AOR: 0.83, 95% CI: 0.73-0.94, P=0.003) and more likely to have BMS (AOR: 1.26, 95% CI: 1.11-1.45, P=0.001). Over the 11-year period observed, there were increases in PCI following STEMIs in both HIV-positive and HIV-negative patients (all P trend <0.001). There were significant increases in the use of DES in HIV-negative patients [adjusted odds ratio (AOR) per year: 1.07, 95% CI: 1.06-1.09, P trend <0.001] and significant decreases in the use of BMS (AOR per year: 0.93, 95% CI: 0.92-0.94, P trend <0.001). Significant trends showing changed practice patterns in the use of DES and BMS among HIV-positive patients were not observed. Conclusion Over a decade, there were significant increases in the use of PCI following STEMIs in both HIV-negative and HIV-positive patients. Although HIV-positive patients presenting with STEMIs were as likely as HIV-negative patients to undergo PCI, they were less likely to be treated with DES and more likely to receive BMS. Highlighting these observations will hopefully bring renewed attention to best practices for all STEMI patients.

Original languageEnglish (US)
Pages (from-to)239-245
Number of pages7
JournalCoronary Artery Disease
Volume28
Issue number3
DOIs
StatePublished - 2017

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Stents
HIV
Drug-Eluting Stents
Percutaneous Coronary Intervention
Myocardial Infarction
Metals
Odds Ratio
Confidence Intervals
ST Elevation Myocardial Infarction
Practice Guidelines
Inpatients

Keywords

  • HIV
  • ST-segment elevation myocardial infarctions
  • stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

HIV status and type of coronary stent placed in patients presenting with ST-elevation myocardial infarction. / Albaeni, Aiham; Harris, Che'; Eid, Shaker M; Abougergi, Marwan S.; Wright, Scott.

In: Coronary Artery Disease, Vol. 28, No. 3, 2017, p. 239-245.

Research output: Contribution to journalArticle

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title = "HIV status and type of coronary stent placed in patients presenting with ST-elevation myocardial infarction",
abstract = "Background Drug-eluting stents (DES) outperform bare-metal stents (BMS) in reducing target vessel revascularization following a percutaneous coronary intervention (PCI). Little is known about the types of stents placed in HIV-positive patients presenting with ST-segment elevation myocardial infarctions (STEMIs). Methods We used the 2003-2013 National Inpatient Sample to identify adults of 18 years or older presenting with STEMI. We evaluated differences in stent type placed following STEMIs on the basis of HIV status. Temporal trends in the use of PCI, DES, and BMS were studied on the basis of HIV status. Results Of 1 695 947 patients with STEMI, 5887 (0.3{\%}) were HIV-positive patients. Following STEMIs, HIV-positive patients were equally likely to have PCI compared with HIV-negative patients [adjusted odds ratio (AOR): 1.04, 95{\%} confidence interval (CI): 0.89-1.21, P=0.63]. However, HIV-positive patients were less likely to have DES (AOR: 0.83, 95{\%} CI: 0.73-0.94, P=0.003) and more likely to have BMS (AOR: 1.26, 95{\%} CI: 1.11-1.45, P=0.001). Over the 11-year period observed, there were increases in PCI following STEMIs in both HIV-positive and HIV-negative patients (all P trend <0.001). There were significant increases in the use of DES in HIV-negative patients [adjusted odds ratio (AOR) per year: 1.07, 95{\%} CI: 1.06-1.09, P trend <0.001] and significant decreases in the use of BMS (AOR per year: 0.93, 95{\%} CI: 0.92-0.94, P trend <0.001). Significant trends showing changed practice patterns in the use of DES and BMS among HIV-positive patients were not observed. Conclusion Over a decade, there were significant increases in the use of PCI following STEMIs in both HIV-negative and HIV-positive patients. Although HIV-positive patients presenting with STEMIs were as likely as HIV-negative patients to undergo PCI, they were less likely to be treated with DES and more likely to receive BMS. Highlighting these observations will hopefully bring renewed attention to best practices for all STEMI patients.",
keywords = "HIV, ST-segment elevation myocardial infarctions, stents",
author = "Aiham Albaeni and Che' Harris and Eid, {Shaker M} and Abougergi, {Marwan S.} and Scott Wright",
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T1 - HIV status and type of coronary stent placed in patients presenting with ST-elevation myocardial infarction

AU - Albaeni, Aiham

AU - Harris, Che'

AU - Eid, Shaker M

AU - Abougergi, Marwan S.

AU - Wright, Scott

PY - 2017

Y1 - 2017

N2 - Background Drug-eluting stents (DES) outperform bare-metal stents (BMS) in reducing target vessel revascularization following a percutaneous coronary intervention (PCI). Little is known about the types of stents placed in HIV-positive patients presenting with ST-segment elevation myocardial infarctions (STEMIs). Methods We used the 2003-2013 National Inpatient Sample to identify adults of 18 years or older presenting with STEMI. We evaluated differences in stent type placed following STEMIs on the basis of HIV status. Temporal trends in the use of PCI, DES, and BMS were studied on the basis of HIV status. Results Of 1 695 947 patients with STEMI, 5887 (0.3%) were HIV-positive patients. Following STEMIs, HIV-positive patients were equally likely to have PCI compared with HIV-negative patients [adjusted odds ratio (AOR): 1.04, 95% confidence interval (CI): 0.89-1.21, P=0.63]. However, HIV-positive patients were less likely to have DES (AOR: 0.83, 95% CI: 0.73-0.94, P=0.003) and more likely to have BMS (AOR: 1.26, 95% CI: 1.11-1.45, P=0.001). Over the 11-year period observed, there were increases in PCI following STEMIs in both HIV-positive and HIV-negative patients (all P trend <0.001). There were significant increases in the use of DES in HIV-negative patients [adjusted odds ratio (AOR) per year: 1.07, 95% CI: 1.06-1.09, P trend <0.001] and significant decreases in the use of BMS (AOR per year: 0.93, 95% CI: 0.92-0.94, P trend <0.001). Significant trends showing changed practice patterns in the use of DES and BMS among HIV-positive patients were not observed. Conclusion Over a decade, there were significant increases in the use of PCI following STEMIs in both HIV-negative and HIV-positive patients. Although HIV-positive patients presenting with STEMIs were as likely as HIV-negative patients to undergo PCI, they were less likely to be treated with DES and more likely to receive BMS. Highlighting these observations will hopefully bring renewed attention to best practices for all STEMI patients.

AB - Background Drug-eluting stents (DES) outperform bare-metal stents (BMS) in reducing target vessel revascularization following a percutaneous coronary intervention (PCI). Little is known about the types of stents placed in HIV-positive patients presenting with ST-segment elevation myocardial infarctions (STEMIs). Methods We used the 2003-2013 National Inpatient Sample to identify adults of 18 years or older presenting with STEMI. We evaluated differences in stent type placed following STEMIs on the basis of HIV status. Temporal trends in the use of PCI, DES, and BMS were studied on the basis of HIV status. Results Of 1 695 947 patients with STEMI, 5887 (0.3%) were HIV-positive patients. Following STEMIs, HIV-positive patients were equally likely to have PCI compared with HIV-negative patients [adjusted odds ratio (AOR): 1.04, 95% confidence interval (CI): 0.89-1.21, P=0.63]. However, HIV-positive patients were less likely to have DES (AOR: 0.83, 95% CI: 0.73-0.94, P=0.003) and more likely to have BMS (AOR: 1.26, 95% CI: 1.11-1.45, P=0.001). Over the 11-year period observed, there were increases in PCI following STEMIs in both HIV-positive and HIV-negative patients (all P trend <0.001). There were significant increases in the use of DES in HIV-negative patients [adjusted odds ratio (AOR) per year: 1.07, 95% CI: 1.06-1.09, P trend <0.001] and significant decreases in the use of BMS (AOR per year: 0.93, 95% CI: 0.92-0.94, P trend <0.001). Significant trends showing changed practice patterns in the use of DES and BMS among HIV-positive patients were not observed. Conclusion Over a decade, there were significant increases in the use of PCI following STEMIs in both HIV-negative and HIV-positive patients. Although HIV-positive patients presenting with STEMIs were as likely as HIV-negative patients to undergo PCI, they were less likely to be treated with DES and more likely to receive BMS. Highlighting these observations will hopefully bring renewed attention to best practices for all STEMI patients.

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