Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2022; 14(7): 427-437
Published online Jul 26, 2022. doi: 10.4330/wjc.v14.i7.427
National trend of heart failure and other cardiovascular diseases in people living with human immunodeficiency virus
Dae Yong Park, Seokyung An, Maria Emilia Romero, Mukunthan Murthi, Ramtej Atluri
Dae Yong Park, Department of Medicine, Cook County Health, Chicago, IL 60612, United States
Seokyung An, Department of Biomedical Science, Seoul National University Graduate School, Seoul 03080, South Korea
Maria Emilia Romero, Mukunthan Murthi, Ramtej Atluri, Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States
Author contributions: Park DY and An SK designed the research; Park DY and An SK performed the research; Park DY and An SK contributed analytic tools; Park DY and An SK analyzed the data; Park DY, An SK, Romero ME, Murthi M, and Atluri R wrote the paper, validated the results, and reviewed and edited the drafts.
Institutional review board statement: This study was exempt from institutional review board as it solely used deidentified data openly and readily available in a public database.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest relevant to this study.
Data sharing statement: All data used in this study are openly available in the public website of Healthcare Cost and Utilization Project (HCUP) at https://www.hcup-us.ahrq.gov/nisoverview.jsp.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dae Yong Park, MD, Doctor, Department of Medicine, Cook County Health, 1969 W Ogden Avenue, Chicago, IL 60612, United States. daeyongp@gmail.com
Received: April 7, 2022
Peer-review started: April 7, 2022
First decision: May 12, 2022
Revised: May 13, 2022
Accepted: June 17, 2022
Article in press: June 17, 2022
Published online: July 26, 2022
Abstract
BACKGROUND

As people living with human immunodeficiency virus (HIV) (PLWH) enjoy longer life expectancy with highly effective antiretroviral therapy, they are encountering challenging cardiovascular health risks.

AIM

To retrospectively examine the increasing burden of cardiovascular diseases in PLWH over the past decade.

METHODS

All hospitalizations for heart failure (HF), ischemic heart disease (IHD), and cerebrovascular disease (CeVD) in PLWH were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and ICD-10-CM codes in the National Inpatient Sample from 2008 to 2018. Outcomes included number of hospitalizations, in-hospital mortality, length of stay, and total hospital charge. Trend of the outcomes from 2008 to 2018 were analyzed using Cochran-Armitage trend test and simple linear regression.

RESULTS

The number of hospitalizations for HF in PLWH increased from 4212 in 2008 to 6700 in 2018 (Ptrend < 0.01). Similar increasing trend was seen with those for IHD and CeVD over the decade (Ptrend < 0.01). A decreasing trend of in-hospital mortality was observed in all hospitalizations of PLWH (Ptrend < 0.01) and CeVD in PLWH (Ptrend < 0.01), but not in those for HF (Ptrend = 0.67) and IHD (Ptrend = 0.13). The trend of length of stay was decreasing in all hospitalizations of PLWH (Ptrend < 0.01), but increasing in those for HF in PLWH (Ptrend < 0.01). An increasing trend of total hospital charge was observed in hospitalizations for HF, IHD, and CeVD (Ptrend < 0.01).

CONCLUSION

The burden of cardiovascular diseases has significantly increased in hospitalizations of PLWH from 2008 to 2018. Continued efforts are needed to address the additional cardiovascular risks in this vulnerable population.

Keywords: Cardiovascular, Heart failure, Trend, Human immunodeficiency virus, People living with human immunodeficiency virus

Core Tip: People living with human immunodeficiency virus (HIV) are at risk of developing cardiovascular diseases, including heart failure, but recent trends in the number of hospitalizations for various cardiovascular causes have not been examined on a national level. This study sought to analyze the trend in the number of hospitalizations for different cardiovascular diseases in people living with HIV to highlight the rising importance of cardiovascular diseases in this vulnerable population. More studies are needed to address the additional cardiovascular risks in people living with HIV, and tailored approach may be beneficial when managing and treating this population.