Increased Sudden Cardiac Death Rate Among HIV Patients

SCD patients more likely to be older and to have had MI, heart failure

WEDNESDAY, May 16 (HealthDay News) -- Patients with HIV/AIDS have a significantly increased risk of sudden cardiac death (SCD), according to a study published in the May 22 issue of the Journal of the American College of Cardiology.

Zian H. Tseng, M.D., of the University of California in San Francisco, and associates conducted a retrospective study of 2,860 HIV patients treated at a public HIV clinic in San Francisco from April 2000 to August 2009. Data were collected on deaths, cause of death, and clinical characteristics, and the link between HIV/AIDS and SCD was investigated.

During a median follow-up of 3.7 years, the researchers identified 230 deaths. Of these, 57 percent were due to AIDS; 14 percent met the criteria for SCD; 11 percent were due to natural causes; and 19 percent were due to overdoses, suicides, and unknown causes. Eighty-six percent of the cardiac deaths (30 of 35) were due to SCD. The mean SCD rate was 4.5-fold higher than expected, at 2.6 per 1,000 person-years. Compared with AIDS deaths, SCD occurred in older patients (49.0 versus 44.9 years; P = 0.02). SCDs had a significantly higher prevalence of prior myocardial infarction, cardiomyopathy, heart failure, and arrhythmia than AIDS and natural deaths combined.

"SCDs account for most cardiac and many non-AIDS natural deaths in HIV-infected patients," the authors write. "Further investigation is needed to ascertain underlying mechanisms, which may include inflammation, antiretroviral therapy interruption, and concomitant medications."

One author disclosed a financial relationship with Biotronik.

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