Brief Report: Insomnia and Risk of Myocardial Infarction Among People With HIV
| Autor: | Brandon R. Luu, Robin M. Nance, Joseph A. C. Delaney, Stephanie A. Ruderman, Susan R. Heckbert, Matthew J. Budoff, William C. Mathews, Richard D. Moore, Matthew J. Feinstein, Greer A. Burkholder, Michael J. Mugavero, Joseph J. Eron, Michael S. Saag, Mari M. Kitahata, Heidi M. Crane, Bridget M. Whitney |
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| Rok vydání: | 2022 |
| Předmět: |
Acquired Immunodeficiency Syndrome
Prevention insomnia Clinical Sciences Myocardial Infarction HIV HIV Infections Cardiovascular type 2 myocardial infarction Heart Disease Good Health and Well Being Infectious Diseases Clinical Research Sleep Initiation and Maintenance Disorders Virology Public Health and Health Services Humans HIV/AIDS Pharmacology (medical) Longitudinal Studies type 1 myocardial infarction Heart Disease - Coronary Heart Disease |
| Zdroj: | Journal of acquired immune deficiency syndromes (1999), vol 90, iss 1 |
| ISSN: | 1525-4135 |
| DOI: | 10.1097/qai.0000000000002910 |
| Popis: | BackgroundInsomnia is common among people with HIV (PWH) and may be associated with increased risk of myocardial infarction (MI). This study examines the association between insomnia and MI by MI type among PWH.SettingLongitudinal cohort study of PWH at 5 Centers for AIDS Research Network of Integrated Clinical Systems sites.MethodsClinical data and patient-reported measures and outcomes from PWH in care between 2005 and 2018 were used in this study. Insomnia, measured at baseline, was defined as having difficulty falling or staying asleep with bothersome symptoms. The Centers for AIDS Research Network of Integrated Clinical Systems centrally adjudicates MIs using expert reviewers, with distinction between type 1 MI (T1MI) and type 2 MI (T2MI). Associations between insomnia and first incident MI by MI type were measured using separate Cox proportional hazard models adjusted for age, sex, race/ethnicity, traditional cardiovascular disease risk factors (hypertension, dyslipidemia, poor kidney function, diabetes, and smoking), HIV markers (antiretroviral therapy, viral suppression, and CD4 cell count), and stimulant use (cocaine/crack and methamphetamine).ResultsAmong 12,448 PWH, 48% reported insomnia. Over a median of 4.4 years of follow-up, 158 T1MIs and 109 T2MIs were identified; approximately half of T2MIs were attributed to sepsis or stimulant use. After adjustment for potential confounders, we found no association between insomnia and T1MI (hazard ratio = 1.05, 95% confidence interval: 0.76 to 1.45) and a 65% increased risk of T2MI among PWH reporting insomnia compared with PWH without insomnia (hazard ratio = 1.65, 95% confidence interval: 1.11 to 2.45).ConclusionsPWH reporting insomnia are at an increased risk of T2MI, but not T1MI, compared with PWH without insomnia, highlighting the importance of distinguishing MI types among PWH. |
| Databáze: | OpenAIRE |
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