Increased sudden cardiac death rate among HIV patients

Zian H. Tseng, M.D., of the University of California in San Francisco, and associates conducted a retrospective study of 2,860 HIV patients treated at a public HIV clinic in San Francisco from April 2000 to August 2009. Data were collected on deaths, cause of death, and clinical characteristics, and the link between HIV/AIDS and SCD was investigated.

During a median follow-up of 3.7 years, the researchers identified 230 deaths. Of these, 57 percent were due to AIDS; 14 percent met the criteria for SCD; 11 percent were due to natural causes; and 19 percent were due to overdoses, suicides, and unknown causes. Eighty-six percent of the cardiac deaths (30 of 35) were due to SCD. The mean SCD rate was 4.5-fold higher than expected, at 2.6 per 1,000 person-years. Compared with AIDS deaths, SCD occurred in older patients (49.0 versus 44.9 years; P = 0.02). SCDs had a significantly higher prevalence of prior myocardial infarction, cardiomyopathy, heart failure, and arrhythmia than AIDS and natural deaths combined.

"SCDs account for most cardiac and many non-AIDS natural deaths in HIV-infected patients," the authors write. "Further investigation is needed to ascertain underlying mechanisms, which may include inflammation, antiretroviral therapy interruption, and concomitant medications."

One author disclosed a financial relationship with Biotronik.

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Journal reference: Journal of the American College of Cardiology

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