Background: 

There are limited data on the outcomes of acute myocardial infarction–cardiogenic shock (AMI-CS) in patients with HIV infection and AIDS.

Setting: 

Twenty percent sample of all US hospitals.

Methods: 

A retrospective cohort of AMI-CS during 2000–2017 from the National Inpatient Sample was evaluated for concomitant HIV and AIDS. Outcomes of interest included in-hospital mortality and use of cardiac procedures. A subgroup analysis was performed for those with and without AIDS within the HIV cohort.

Results: 

A total 557,974 AMI-CS admissions were included, with HIV and AIDS in 1321 (0.2%) and 985 (0.2%), respectively. The HIV cohort was younger (54.1 vs. 69.0 years), more often men, of non-White race, uninsured, from a lower socioeconomic status, and with higher comorbidity (all P < 0.001). The HIV cohort had comparable multiorgan failure (37.8% vs. 39.0%) and cardiac arrest (28.7% vs. 27.4%) (P > 0.05). The cohorts with and without HIV had comparable rates of coronary angiography (70.2% vs. 69.0%; P = 0.37) but less frequent early coronary angiography (hospital day zero) (39.1% vs. 42.5%; P < 0.001). The cohort with HIV had higher unadjusted but comparable adjusted in-hospital mortality compared with those without [26.9% vs. 37.4%; adjusted odds ratio 1.04 (95% confidence interval: 0.90 to 1.21); P = 0.61]. In the HIV cohort, AIDS was associated with higher in-hospital mortality [28.8% vs. 21.1%; adjusted odds ratio 4.12 (95% confidence interval: 1.89 to 9.00); P < 0.001].

Conclusions: 

The cohort with HIV had comparable rates of cardiac procedures and in-hospital mortality; however, those with AIDS had higher in-hospital mortality.

中文翻译：

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人类免疫缺陷病毒感染对心源性休克急性心肌梗死的治疗和结果的影响

背景： 

HIV感染和艾滋病患者的急性心肌梗死-心源性休克（AMI-CS）的结局资料有限。

设置： 

美国所有医院中有20％的样本。

方法： 

从国家住院患者样本中回顾了2000-2017年间AMI-CS的回顾性队列，以评估其伴随的艾滋病毒和艾滋病。感兴趣的结果包括院内死亡率和心脏手术的使用。在艾滋病病毒队列中，对有或没有艾滋病的人进行了亚组分析。

结果： 

总共纳入557,974例AMI-CS入院病例，其中HIV和AIDS分别为1321（0.2％）和985（0.2％）。在HIV人群年轻（54.1对比69.0年），更多的人，非白种人，没有保险，从社会经济地位较低，并具有较高的合并症（均P <0.001）。在HIV人群具有相当的多器官衰竭（37.8％对39.0％）和心脏骤停（28.7％对27.4％）（P > 0.05）。有和没有艾滋病毒的人群冠状动脉造影的发生率相当（70.2％vs. 69.0％；P = 0.37），但早期冠状动脉造影的频率较低（医院零日）（39.1％vs. 42.5％；P<0.001）。与未感染艾滋病毒的人群相比，未接受艾滋病毒的人群的院内死亡率更高，与未接受艾滋病毒的人群[26.9％对37.4％]相当。调整后的优势比为1.04（95％置信区间：0.90至1.21）; P = 0.61]。在艾滋病毒人群中，艾滋病与更高的院内死亡率相关[28.8％对21.1％；调整比值比4.12（95％置信区间：1.89至9.00）; P <0.001]。

结论： 

与人群HIV过的心脏手术和住院死亡率可比费率; 但是，艾滋病患者的院内死亡率较高。