[indices] Association of ARV therapy with myocardial infarction

["INDICES Moderator" <indices@healthnet.org>]

Cross-posted from E-DRUG

E-DRUG: Association of antiretroviral therapy with myocardial infarction
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I copy below the abstract of a JAMA article as presented in today's (4
May 2005) DrugInfoZone postings. The JAMA article refers to an
association of long-term HAART with myocardial infarction. Might be of
interest to e-drug readers.

 Thanks.

Shanthi Pal, M.Pharm PhD
Quality Assurance and Safety: Medicines
Department of Medicines Policy and Standards
World Health Organization
Geneva, Switzerland
Tel: + 41 22 791 1318
E-mail: pals@who.int
Website: http://www.who.int/medicines

As posted on DrugInfozone (http://www.druginfozone.nhs.uk) 4 May 2005:
An article discussing the cardiovascular risk factors associated with
 highly active anti-retroviral therapy (HAART) has been published in
JAMA. The author discusses new findings from a large observational study
presented at the 12th Annual Retrovirus Conference which suggests that
the risk of myocardial infarction (MI) increases with longer exposure to
HAART.

The researchers found that incidence of MI increased from 1.39 per 1000
patient-years in those who had not been exposed to antiretroviral drugs
to 2.53 per 1000 patient-years in those exposed to the drugs for less
than 1 year and 6.07 per 1000 patient-years in those exposed to the
drugs for at least 6 years.

The findings were derived from the Data Collection on Adverse Events of
Anti-HIV Drugs (known as the D:A:D Study), begun in 1999, which as of
February 2004 included more than 76 000 patient-years of follow-up on 23
441 patients in Europe, Australia, and the United States. These results
were especially surprising, due to the young age of those studied
(median age of around 39 years. After adjusting for other potential risk
factors, the researchers determined there was a 1.17-fold increased risk
of a first MI per additional year of exposure to HAART. Similar risks
were found after including repeat MIs.

Reference: JAMA 2005; 293: 2081