Myocardial infarction among Danish HIV-infected individuals: Population attributable fractions associated with smoking

Line D Rasmussen, Marie Helleberg, Margaret May, Shoaib Afzal, Gitte Kronborg, Carsten S Larsen, Court Pedersen, Jan Gerstoft, Børge G Nordestgaard, Niels Obel

116 Citationer (Scopus)


BACKGROUND:  HIV-infected individuals have increased risk of myocardial infarction (MI), but the contribution from smoking and potentiating effects of HIV are controversial.

METHODS:  From the Danish HIV Cohort Study and the Copenhagen General Population Study, we identified 3,251 HIV-infected individuals and 13,004 population controls matched on age and gender. Data on MI were obtained from The National Hospital Registry and The National Registry of Causes of Death. We calculated adjusted incidence rate ratios (aIRR) for risk of MI and population attributable fractions (PAF) of MI associated with smoking.

RESULTS:  In never-smokers, HIV was not associated with an increased risk of MI (aIRR: 1.01; 95% CI: 0.41-2.54). In previous and current smokers, HIV was associated with a substantially increased risk of MI [aIRR: 1.78 (95% CI: 0.75-4.24) and 2.83 (95% CI: 1.71-4.70)]. The PAF associated with ever-smoking (previous or current) was 72% (95% CI: 55-82%) for HIV-infected individuals and 24% (95% CI: 3-40%) for population controls. If all current smokers stopped smoking, 42% (95% CI: 21-57%) and 21% (95%CI: 12-28%) of all MIs could potentially be avoided in these two populations.

CONCLUSIONS:  Smoking is associated with a higher risk of MI in the HIV-infected population than in the background population. Almost 3 of 4 MIs among HIV-infected individuals are associated with ever smoking compared to only 1 of 4 MIs among population controls. Smoking cessation could potentially prevent more than 40% of MIs among HIV-infected individuals why smoking cessation should be one of the main focuses in modern HIV care.

TidsskriftClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Udgave nummer9
Sider (fra-til)1415-1423
StatusUdgivet - 2015


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