Evidence map›Paper›PMID 34133860›Full record

ArticleThe New England journal of medicine2021

Sudden Cardiac Death and Myocardial Fibrosis, Determined by Autopsy, in Persons with HIV.

Zian H Tseng, Ellen Moffatt, Anthony Kim, Eric Vittinghoff, Phil Ursell, Andrew Connolly, Jeffrey E Olgin, Joseph K Wong, Priscilla Y Hsue

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The New England journal of medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 52 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
52citing papers in PubMed, 3 pooled it
12.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

52 citing papers in PubMed, 3 syntheses or guidelines pooled it, 68 citations in OpenAlex.

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  5. Long-term subclinical cardiac damage in people living with human immunodeficiency virus.International journal of cardiology. Heart & vasculature · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Zian H TsengFrom the Section of Cardiac Electrophysiology, Cardiology Division, Department of Medicine (Z.H.T., J.E.O.), the Departments of Neurology (A.K.), Epidemiology and Biostatistics (E.V.), and Pathology (P.U., A.C.), the Division of Infectious Disease, Veterans Affairs Medical Center (J.K.W.), and the Division of Cardiology, Zuckerberg San Francisco General Hospital (P.Y.H.), University of California, San Francisco, and the Office of the Chief Medical Examiner, City and County of San Francisco (E.M.) - all in San Francisco.
Ellen MoffattFrom the Section of Cardiac Electrophysiology, Cardiology Division, Department of Medicine (Z.H.T., J.E.O.), the Departments of Neurology (A.K.), Epidemiology and Biostatistics (E.V.), and Pathology (P.U., A.C.), the Division of Infectious Disease, Veterans Affairs Medical Center (J.K.W.), and the Division of Cardiology, Zuckerberg San Francisco General Hospital (P.Y.H.), University of California, San Francisco, and the Office of the Chief Medical Examiner, City and County of San Francisco (E.M.) - all in San Francisco.
Anthony KimFrom the Section of Cardiac Electrophysiology, Cardiology Division, Department of Medicine (Z.H.T., J.E.O.), the Departments of Neurology (A.K.), Epidemiology and Biostatistics (E.V.), and Pathology (P.U., A.C.), the Division of Infectious Disease, Veterans Affairs Medical Center (J.K.W.), and the Division of Cardiology, Zuckerberg San Francisco General Hospital (P.Y.H.), University of California, San Francisco, and the Office of the Chief Medical Examiner, City and County of San Francisco (E.M.) - all in San Francisco.
Eric VittinghoffFrom the Section of Cardiac Electrophysiology, Cardiology Division, Department of Medicine (Z.H.T., J.E.O.), the Departments of Neurology (A.K.), Epidemiology and Biostatistics (E.V.), and Pathology (P.U., A.C.), the Division of Infectious Disease, Veterans Affairs Medical Center (J.K.W.), and the Division of Cardiology, Zuckerberg San Francisco General Hospital (P.Y.H.), University of California, San Francisco, and the Office of the Chief Medical Examiner, City and County of San Francisco (E.M.) - all in San Francisco.
Phil UrsellFrom the Section of Cardiac Electrophysiology, Cardiology Division, Department of Medicine (Z.H.T., J.E.O.), the Departments of Neurology (A.K.), Epidemiology and Biostatistics (E.V.), and Pathology (P.U., A.C.), the Division of Infectious Disease, Veterans Affairs Medical Center (J.K.W.), and the Division of Cardiology, Zuckerberg San Francisco General Hospital (P.Y.H.), University of California, San Francisco, and the Office of the Chief Medical Examiner, City and County of San Francisco (E.M.) - all in San Francisco.
Andrew ConnollyFrom the Section of Cardiac Electrophysiology, Cardiology Division, Department of Medicine (Z.H.T., J.E.O.), the Departments of Neurology (A.K.), Epidemiology and Biostatistics (E.V.), and Pathology (P.U., A.C.), the Division of Infectious Disease, Veterans Affairs Medical Center (J.K.W.), and the Division of Cardiology, Zuckerberg San Francisco General Hospital (P.Y.H.), University of California, San Francisco, and the Office of the Chief Medical Examiner, City and County of San Francisco (E.M.) - all in San Francisco.
Jeffrey E OlginFrom the Section of Cardiac Electrophysiology, Cardiology Division, Department of Medicine (Z.H.T., J.E.O.), the Departments of Neurology (A.K.), Epidemiology and Biostatistics (E.V.), and Pathology (P.U., A.C.), the Division of Infectious Disease, Veterans Affairs Medical Center (J.K.W.), and the Division of Cardiology, Zuckerberg San Francisco General Hospital (P.Y.H.), University of California, San Francisco, and the Office of the Chief Medical Examiner, City and County of San Francisco (E.M.) - all in San Francisco.
Joseph K WongFrom the Section of Cardiac Electrophysiology, Cardiology Division, Department of Medicine (Z.H.T., J.E.O.), the Departments of Neurology (A.K.), Epidemiology and Biostatistics (E.V.), and Pathology (P.U., A.C.), the Division of Infectious Disease, Veterans Affairs Medical Center (J.K.W.), and the Division of Cardiology, Zuckerberg San Francisco General Hospital (P.Y.H.), University of California, San Francisco, and the Office of the Chief Medical Examiner, City and County of San Francisco (E.M.) - all in San Francisco.
Priscilla Y HsueFrom the Section of Cardiac Electrophysiology, Cardiology Division, Department of Medicine (Z.H.T., J.E.O.), the Departments of Neurology (A.K.), Epidemiology and Biostatistics (E.V.), and Pathology (P.U., A.C.), the Division of Infectious Disease, Veterans Affairs Medical Center (J.K.W.), and the Division of Cardiology, Zuckerberg San Francisco General Hospital (P.Y.H.), University of California, San Francisco, and the Office of the Chief Medical Examiner, City and County of San Francisco (E.M.) - all in San Francisco.
San Diego Cardiac Center · USCancer Research And Biostatistics · USOffice of the Chief Medical Examiner · CASan Francisco General Hospital · USVeterans Health Administration · US

Funding

Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MALLORY O JOHNSON · 1988 to 2026
$93.6M
Cardiac Pathology and Risk Prediction for Sudden Cardiac Death in Patients with HIVR01HL126555 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI TSENG, ZIAN H · 2014 to 2017
$3.1M
NHLBI NIH HHS R01 HL126555NHLBI NIH HHS R01HL126555NIAID NIH HHS P30 AI027763
6 · The paper itself

Abstract

backgroundThe incidence of sudden cardiac death and sudden death caused by arrhythmia, as determined by autopsy, in persons with human immunodeficiency virus (HIV) infection has not been clearly established.

methodsBetween February 1, 2011, and September 16, 2016, we prospectively identified all new deaths due to out-of-hospital cardiac arrest among persons 18 to 90 years of age, with or without known HIV infection, for comprehensive autopsy and toxicologic and histologic testing. We compared the rates of sudden cardiac death and sudden death caused by arrhythmia between groups.

resultsOf 109 deaths from out-of-hospital cardiac arrest among 610 unexpected deaths in HIV-positive persons, 48 met World Health Organization criteria for presumed sudden cardiac death; of those, fewer than half (22) had an arrhythmic cause. A total of 505 presumed sudden cardiac deaths occurred between February 1, 2011, and March 1, 2014, in persons without known HIV infection. Observed incidence rates of presumed sudden cardiac death were 53.3 deaths per 100,000 person-years among persons with known HIV infection and 23.7 deaths per 100,000 person-years among persons without known HIV infection (incidence rate ratio, 2.25; 95% confidence interval [CI], 1.37 to 3.70). Observed incidence rates of sudden death caused by arrhythmia were 25.0 and 13.3 deaths per 100,000 person-years, respectively (incidence rate ratio, 1.87; 95% CI, 0.93 to 3.78). Among all presumed sudden cardiac deaths, death due to occult drug overdose was more common in persons with known HIV infection than in persons without known HIV infection (34% vs. 13%). Persons who were HIV-positive had higher histologic levels of interstitial myocardial fibrosis than persons without known HIV infection.

conclusionsIn this postmortem study, the rates of presumed sudden cardiac death and myocardial fibrosis were higher among HIV-positive persons than among those without known HIV infection. One third of apparent sudden cardiac deaths in HIV-positive persons were due to occult drug overdose. (Supported by the National Heart, Lung, and Blood Institute.).

Indexed as

AdolescentAdultAgedAged, 80 and overAutopsyCardiomyopathiesCause of DeathDeath, Sudden, CardiacDrug OverdoseFibrosisHIV InfectionsHIV SeropositivityHumansMiddle AgedMyocardiumOut-of-Hospital Cardiac Arrest

Identifiers

PMID34133860
PMCPMC8415173
OpenAlexW3168262242

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.