EMORY STUDY FINDS HIV IS NOT AN INDEPENDENT RISK FACTOR FOR SEVERE HEART DISEASE

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EMORY STUDY FINDS HIV IS NOT AN INDEPENDENT RISK FACTOR FOR SEVERE HEART DISEASE
18 February 2007 - Emory University

Infection with human immunodeficiency virus is no longer an automatic death sentence, thanks to the use of highly active anti-retroviral therapy. However, several studies questions have suggested that HIV infection poses a serious threat to the heart , specifically, that HIV positivity leads to an increased risk for the development of angiographically severe coronary artery disease.

But Emory research presented by Amar D. Patel, MD, today at the American College of Cardiology 54th Annual Scientific Sessions in Orlando today reaches a different conclusion.

Emory researchers studied all patients who underwent cardiac catheterization (due to acute coronary syndrome or an abnormal cardiac stress test) at Grady Memorial Hospital in Atlanta between January 2001 and December 2001. The patients were evaluated for HIV infection, common cardiac risk factors, HAART, and findings on coronary angiography.

"We then used multivariate analyses to determine the relationship between HIV status and angiographically severe CAD in 525 patients," explains Emory Heart Center cardiologist and research team member Srikanth Sola, MD. "We found that 5 percent were HIV positive and 21 percent were admitted with a heart attack. But only 1.4 percent of the heart attack group was HIV positive."

Cardiac catheterization revealed that 213 patients (45%) had severe CAD stenosis and 14 patients of these patients were HIV positive. "At first, it appeared that HIV status was significantly associated with angiographically severe heart disease. However, after we adjusted for age, gender, hypertension, diabetes, high cholesterol levels and tobacco use, HIV status was no longer associated with severe CAD," says Dr. Sola. "In fact, there was no significant relationship between angiographically significant CAD and HAART, CD4 count, or HIV viral load."

The Emory researchers concluded that, although HIV infection is common in an urban population referred for cardiac catheterization, it was not a significant risk factor for severe CAD. "This suggests that factors other than HIV play a significant role in the development of severe CAD in patients who are HIV positive. Lifestyle and traditional cardiac risk factors (hypertension, hyperlipidemia, tobacco, etc.) appear to play a larger role than HIV in the development of CAD," Dr. Sola states.

He adds that the researchers were surprised by their findings. "We expected to see a strong relationship between HIV status and angiographically significant CAD," Dr. Sola says. "However, earlier studies were conducted in an era when effective therapy against HIV was not available. At that time, the severity of HIV infection may have been greater, leading to the association between HIV infection and CAD that was noted in these earlier studies." In addition to Dr. Sola and Dr. Patel, the Emory research team included Tarek Helmy, MD (principal investigator); Divya Gupta, MD; Muhammad Mir, MD; Megan Price, MD; Patrick Caneer, MD; Faiz Cheema, MD; and Bobby Khan, MD.

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About: Emory University
Emory University is home to nine major academic divisions, numerous centres for advanced study, and a host of prestigious affiliated institutions. In addition to Emory College, the University encompasses a graduate school of arts and sciences; professional schools of medicine, theology, law, nursing, public health, and business; and Oxford College, a two-year undergraduate division on the original campus of Emory in Oxford, Ga.

Emory was founded at Oxford by the Methodist Church in 1836. Led by President James W. Wagner, an award-winning teacher and scholar, the University has 11,300 students and 2,500 faculty members who represent all regions of the United States and more than 100 foreign nations.

Emory University is known for its demanding academics, outstanding undergraduate college of arts and sciences, highly ranked professional schools and state-of-the-art research facilities. For more than a decade Emory has been named one of the country's top 25 national universities by U.S. News & World Report. In addition to its nine schools, the university encompasses The Carter Center, Yerkes National Primate Research Center and Emory Healthcare, a comprehensive metropolitan health care system.

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