Differences between HIV-infected and uninfected adults in the contributions of smoking, diabetes and hypertension to acute coronary syndrome: two parallel case-control studies.

Objectives The aim of the study was to assess the separate contributions of smoking, diabetes and hypertension to acute coronary syndrome (ACS) in HIV-infected adults relative to uninfected adults. Methods Two parallel casecontrol studies were carried out. In the first study, HIV-positive adults diagnosed with ACS between 1997 and 2009 (HIV+/ACS) were matched for age, gender and known duration of HIV infection with HIV-positive adults without ACS (HIV+/noACS), each individual in the HIV+/ACS group being matched with three individuals in the HIV+/noACS group. In the second study, each individual in the HIV+/ACS group in the first study was matched for age, gender and calendar date of ACS diagnosis with three HIV-negative individuals diagnosed with ACS between 1997 and 2009 (HIV/ACS). Each individual in the HIV/ACS group was then matched for age and gender with an HIV-negative adult without ACS (HIV/noACS). After matching, the ratio of numbers of individuals in the HIV+/ACS, HIV+/noACS, HIV/ACS and HIV/noACS groups was therefore 1?:?3?:?3?:?3, respectively. We performed logistic regression analyses to identify risk factors for ACS in each casecontrol study and calculated population attributable risks (PARs) for smoking, diabetes and hypertension in HIV-positive and HIV-negative individuals. Results There were 57 subjects in the HIV+/ACS group, 173 in the HIV+/noACS group, 168 in the HIV/ACS group, and 171 in the HIV/noACS group. Independent risk factors for ACS were smoking [odds ratio (OR) 4.091; 95% confidence interval (CI) 2.0868.438; P?更多