Use of nucleoside reverse transcriptase inhibitors and risk of myocardial infarction in HIV-infected patients enrolled in the D:A:D study: a multi-cohort collaboration

摘要: Background: Whether nucleoside reverse transcriptase inhibitors increase the risk of myocardial infarction in HIV-infected individuals is unclear. Our aim was to explore whether exposure such drugs associated with an excess a large, prospective observational cohort patients. Methods: We used Poisson regression models quantify relation between cumulative, recent (currently or within preceding 6 months), and past use zidovudine, didanosine, stavudine, lamivudine, abacavir development 33 347 patients enrolled D:A:D study. adjusted for cardiovascular factors that are unlikely be aff ected by antiretroviral therapy, cohort, calendar year, other antiretrovirals. Findings: Over 157 912 person-years, 517 had infarction. found no associations rate cumulative lamivudine. By contrast, recent—but not cumulative—use didanosine increased (compared those drugs, relative 1•90, 95% CI 1•47–2•45 [p=0•0001] 1•49, 1•14–1•95 [p=0•003] didanosine); rates were significantly who stopped these more than months previously compared never received drugs. After adjustment predicted 10-year coronary heart disease, both remained (1•49, [p=0•004] didanosine; 1•89, abacavir). Interpretation: There exists exposed months. The does seem explained underlying established present beyond after drug cessation.