Prevalence and Associated Stroke Risk of Human Immunodeficiency Virus-Infected Patients With Atrial Fibrillation - A Nationwide Cohort Study.



Jung, Hyunjean, Yang, Pil-Sung, Jang, Eunsun, Yu, Hee Tae, Kim, Tae-Hoon, Uhm, Jae-Sun, Kim, Jong-Youn, Sung, Jung-Hoon, Pak, Hui-Nam, Lee, Moon-Hyoung
et al (show 2 more authors) (2019) Prevalence and Associated Stroke Risk of Human Immunodeficiency Virus-Infected Patients With Atrial Fibrillation - A Nationwide Cohort Study. Circulation journal : official journal of the Japanese Circulation Society, 83 (12). 2547 - 2554.

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Abstract

BACKGROUND:Patients infected with human immunodeficiency virus (HIV) are at increased risk of cardiovascular diseases. However, little is known regarding the risk of ischemic stroke in HIV-infected individuals with atrial fibrillation (AF).Methods and Results:From the Korean National Health Insurance Service (NHIS) database from January 1, 2005 to December 31, 2016, we analyzed 962,116 patients with prevalent non-valvular AF aged ≥18 years. The overall HIV prevalence in AF patients was 0.17% (1,678 of 962,116). Oral anticoagulant (OAC)-naïve non-valvular AF (NVAF) patients with HIV had increased risks of ischemic stroke/systemic embolism (SE) [adjusted hazard ratio (HR) 1.37; 95% confidence interval (CI), 1.21-1.54], and major bleeding (adjusted HR 1.29; 95% CI, 1.15-1.46), compared with those without HIV. The incidence of ischemic stroke/SE in NVAF patients with HIV without any risk factors was similar to that of those without HIV at intermediate risk (i.e., male CHA2DS2-VASc score of 1) (2.04 vs. 2.18 events per 100 person-years). However, the use of OACs in AF patients with HIV was suboptimal, being only 8.9% at the time of AF diagnosis and 31.8% throughout the study period. CONCLUSIONS:The risks of ischemic stroke/SE and major bleeding were significantly higher in HIV-infected patients compared with non-HIV-infected patients with AF. Despite this, the actual use of OACs among AF patients with HIV was suboptimal.

Item Type: Article
Depositing User: Symplectic Admin
Date Deposited: 10 Dec 2019 11:32
Last Modified: 14 Sep 2022 04:10
DOI: 10.1253/circj.cj-19-0527
Open Access URL: http://doi.org/10.1253/circj.cj-19-0527
URI: https://livrepository.liverpool.ac.uk/id/eprint/3065752