From HIV Medicine Rates of Cardiovascular Disease Following Smoking Cessation in Patients With HIV Infection

August 29, 2011

Rates of Cardiovascular Disease Following Smoking Cessation in Patients With HIV

Infection Results From the D:A:D Study

K Petoumenos; S Worm; P Reiss; S de Wit; A d'Arminio Monforte; C Sabin; N

Friis-Møller; R Weber; P Mercie; C Pradier; W El-Sadr; O Kirk; J

Lundgren; MG Law

Objectives The aim of the study was to estimate the rates of

cardiovascular disease (CVD) events after stopping smoking in patients

with HIV infection.

Methods Patients who reported smoking status and no previous CVD

prior to enrolment in the Data Collection on Adverse Events of Anti-HIV

Drugs (D:A:D) study were included in this study. Smoking status is

collected at each visit as current smoker (yes/no) and ever smoker

(yes/no). Time since stopping smoking was calculated for persons who had

reported current smoking during follow-up and no current smoking

subsequently. Endpoints were: myocardial infarction (MI); coronary heart disease

(CHD: MI plus invasive coronary artery procedure or death from

other CHD); CVD (CHD plus carotid artery endarterectomy or stroke); and

all-cause mortality. Event rates were calculated for never, previous and current

smokers, and smokers who stopped during follow-up. Incidence

rate ratios (IRRs) were determined using Poisson regression adjusted for age,

sex, cohort, calendar year, family history of CVD, diabetes,

lipids, blood pressure and antiretroviral treatment.

Results A total of 27 136 patients had smoking status reported,

with totals of 432, 600, 746 and 1902 MI, CHD, CVD and mortality events,

respectively. The adjusted IRR of CVD in patients who stopped smoking

during follow-up decreased from 2.32 within the first year of stopping

to 1.49 after >3 years compared with those who never smoked. Similar

trends were observed for the MI and CHD endpoints. Reductions in risk

were less pronounced for all-cause mortality.

Conclusion The risk of CVD events in HIV-positive patients

decreased with increasing time since stopping smoking. Smoking cessation efforts

should be a priority in the management of HIV-positive

patients.

From Medscape News 8/15/2011

Just in case anyone needed another reason to quit...

Be well, mes amis

Mike

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