August 24, 2016
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Adults with HIV, depression at elevated risk for MI

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Among adults with HIV, those with major depressive disorder had increased risk for MI compared with those without depression, according to new data.

According to the study background, depression is common in adults with HIV and is associated with CVD in the general population, but the relationship between CVD events and depression in the HIV population was unknown.

Tasneem Khambaty, PhD, and colleagues conducted a cohort study of 26,144 veterans with HIV (mean age, 48 years; 97% men) who participated in the U.S. Department of Veterans Affairs Aging Cohort Study from April 2003 to December 2009.

Participants were stratified by whether they had major depressive disorder (19%) or not (81%). Nine percent of participants had dysthymic disorder.

The primary outcome was incident acute MI or acute MI as an underlying cause of death. Median follow-up was 5.8 years.

During the study period, 1.9% of participants experienced acute MI, Khambaty, from the department of psychology at the University of Miami in Coral Gables, Florida, and colleagues reported.

Major depressive disorder at baseline was associated with incident MI after adjustment for demographics (HR = 1.31; 95% CI, 1.05-1.62), risk factors for CVD (HR = 1.29; 95% CI, 1.04-1.6) and HIV-specific factors (HR = 1.3; 95% CI, 1.05-1.62), Khambaty and colleagues found.

The association was attenuated after further adjustment for hepatitis C, renal disease, substance abuse and hemoglobin level (HR = 1.25; 95% CI, 1-1.56) and use of antidepressants (HR = 1.12; 95% CI, 0.87-1.42), the researchers wrote.

Dysthymic disorder at baseline was not associated with MI in this population (fully adjusted HR = 1.2; 95% CI, 0.9-1.61), they found.

“It is possible that the presence of [major depressive disorder] further exacerbates the persistent inflammatory and coagulatory activation already present in HIV, resulting in higher CVD event rates,” Khambaty and colleagues wrote. – by Erik Swain

Disclosure: Khambaty reports no relevant financial disclosures. Please see the full study for a list of the other researchers’ relevant financial disclosures.