INCREASING RATE OF CARDIAC PROCEDURES AMONG HIV-POSITIVE INDIVIDUALS ON ANTIRETROVIRAL THERAPY FROM 1993-2001

P Braitstein^1,2, B Yip¹, J Montaner^1,3, A Levy^1,2, J Joseph², M Kiely⁴, MV O’Shaughnessy^1,5, RS Hogg^1,2
1British Columbia Centre for Excellence in HIV/AIDS; ²Department of Health Care and Epidemiology, University of British Columbia; ³Department of Medicine, University of British Columbia; ⁴British Columbia Cardiac Registry; ⁵Department of Pathology, University of British Columbia, Vancouver, British Columbia

Objective: To determine the rate of cardiac procedures among persons infected with HIV on antiretrovirals from 1993 – 2001.
Methods: Since 1991, antiretrovirals in British Columbia have been centrally distributed by the B.C. Centre for Excellence in HIV/AIDS. The B.C. Cardiac Registry maintains information regarding all cardiac procedures in British Columbia. These databases were linked to determine the number of cardiac procedures among persons on antiretrovirals. Rates are expressed as cardiac procedures per 1000 active participants (i.e. actively on antiretrovirals) and were calculated from 01/93 to 11/01. Linear regression was used to assess slope (1997–2000).
Results: Of the 63 individuals in the Cardiac Registry who have also received antiretrovirals, there were 97 events: 70 (72%) since 1999. There were 30 open-heart surgeries (53% since 1999), 31 coronary angioplasties (58% since 1999), and 36 diagnostic catheters (the Registry only began collecting this data in 1999). After excluding the diagnostic catheters, procedures since 1999 still represent 56% of all cardiac procedures among HIV-positive individuals on antiretrovirals. The event rates per 1000 active participants, per year, were – [1993: 0.70]; [1994: 2.35]; [1995: 3.37]; [1996: 1.65]; [1997: 0.34]; [1998: 1.57]; [1999: 3.54]; [2000: 6.18]; [2001: 4.23]. Linear regression found an increase of 1.95 procedures per 1000 active participants per year, p=0.013.

Conclusions: These preliminary data suggest a significantly increasing trend of cardiac procedures among HIV-infected individuals receiving antiretroviral therapy.