Clinical Electrophysiology -> Ventricular Arrhythmias -> Clinical Trials / Outcomes D-PO05 - Poster Session V (ID 39) Poster

D-PO05-222 - Association Of Human Immunodeficiency Virus Infection With Out-of-hospital Cardiac Arrest (ID 1315)

 M. Sardana: Nothing relevant to disclose.


Background: Patients with Human Immunodeficiency Virus (HIV) infection are at increased risk of cardiovascular disease, but no prospective study has investigated HIV as a risk factor for cardiac arrest.
Objective: We leveraged state-wide emergency department encounters in California (2005 - 2015) to study the association between HIV and out-of-hospital cardiac arrest (OHCA).
Methods: We utilized the Office of Statewide Health Planning and Development data to evaluate HIV as a predictor for OHCA, adjusting for age, sex, race, income, smoking, alcohol, substance abuse, obesity, hypertension (HTN), diabetes, coronary artery disease, congestive heart failure (CHF), atrial fibrillation, and chronic kidney disease (CKD). We also determined patient characteristics modifying the associations by including interaction terms in multivariable-adjusted models.
Results: Among 18,542,761patients (mean age 47±20 years, 53% women, 43,849 with HIV) followed for a median 6.8 years, 133,983 new OHCA events occurred. Incidence rates in HIV patients were higher than in patients without HIV (19.9 vs. 11.6 OHCA events per 100-person years follow-up). After multivariable adjustment, HIV was associated with a 2.5-fold higher risk of OHCA (hazard ratio 2.47, 95% CI 2.29-2.66, p<0.001). The risk of OHCA with HIV was disproportionately stronger in women and those with HTN, CHF, and CKD (Figure).
Conclusion: In this large prospective study, HIV was associated with 2.5-fold increased risk of OHCA, with synergistic interaction between HIV and female sex, HTN, CHF, and CKD. Future studies should leverage our findings to study the mechanisms underlying this association and the effects of HIV therapies.