Evidence map›Paper›PMID 34488812›Full record

ArticleAIDS research and therapy2021

Acute myocardial infarction associated with abacavir and tenofovir based antiretroviral drug combinations in the United States.

Kunchok Dorjee, Manisha Desai, Tsering Choden, Sanjiv M Baxi, Alan E Hubbard, Arthur L Reingold

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

Article in AIDS research and therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 18% 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
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  3. Review
  4. Article
  5. Article
  6. Article
  7. Article
  8. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Kunchok DorjeeDivision of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA. kdorjee1@jhmi.edu.
Manisha DesaiQuantitative Sciences Unit, Center for Biomedical Informatics Research, Department of Medicine, Stanford University, Palo Alto, CA, USA.
Tsering ChodenSchool of Public Health, Department of Epidemiology and Biostatistics, State University of New York Downstate Medical Center, Brooklyn, NY, USA.
Sanjiv M BaxiDepartment of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
Alan E HubbardDivision of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA.
Arthur L ReingoldDivision of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, CA, USA.
University of California, Berkeley · USStanford University · USSUNY Downstate Health Sciences University · USUniversity of California, San Francisco · US

Funding

Tuberculosis Transmission and Preventive Therapy in Tibetan Children and Young Adults in IndiaK01AI148583 · NIAID · JOHNS HOPKINS UNIVERSITY · PI DORJEE, KUNCHOK · 2020 to 2024
$734k
NIAID NIH HHS K01 AI148583
6 · The paper itself

Abstract

introductionAlthough individual antiretroviral drugs have been shown to be associated with elevated cardiovascular disease (CVD) risk, data are limited on the role of antiretroviral drug combinations. Therefore, we sought to investigate CVD risk associated with antiretroviral drug combinations.

methodsUsing an administrative health-plan dataset, risk of acute myocardial infarction (AMI) associated with current exposure to antiretroviral drug combinations was assessed among persons living with HIV receiving antiretroviral therapy (ART) across the U.S. from October 2009 through December 2014. To account for confounding-by-indication and for factors simultaneously acting as causal mediators and confounders, we applied inverse probability of treatment weighted marginal structural models to longitudinal data of patients.

resultsOver 114,417 person-years (n = 73,071 persons) of ART exposure, 602 cases of AMI occurred at an event rate of 5.26 (95% CI: 4.86, 5.70)/1000 person-years. Of the 14 antiretroviral drug combinations studied, persons taking abacavir-lamivudine-darunavir had the highest incidence rate (IR: 11/1000; 95% CI: 7.4-16.0) of AMI. Risk (HR; 95% CI) of AMI was elevated for current exposure to abacavir-lamivudine-darunavir (1.91; 1.27-2.88), abacavir-lamivudine-atazanavir (1.58; 1.08-2.31), and tenofovir-emtricitabine-raltegravir (1.35; 1.07-1.71). Tenofovir-emtricitabine-efavirenz was associated with reduced risk (0.65; 0.54-0.78). Abacavir-lamivudine-darunavir was associated with increased risk of AMI beyond that expected of abacavir alone, likely attributable to darunavir co-administration. We did not find an elevated risk of AMI when abacavir-lamivudine was combined with efavirenz or raltegravir.

conclusionThe antiretroviral drug combinations abacavir-lamivudine-darunavir, abacavir-lamivudine-atazanavir and tenofovir-emtricitabine-raltegravir were found to be associated with elevated risk of AMI, while tenofovir-emtricitabine-efavirenz was associated with a lower risk. The AMI risk associated with abacavir-lamivudine-darunavir was greater than what was previously described for abacavir, which could suggest an added risk from darunavir. The results should be confirmed in additional studies.

Indexed as

Anti-HIV AgentsHIV-1HIV InfectionsMyocardial InfarctionAbacavirDideoxynucleosidesDrug CombinationsHumansLamivudineTenofovirUnited StatesAbacavirAnti-HIV AgentsDideoxynucleosidesDrug CombinationsLamivudineTenofovirAntiretroviral agentsCardiovascular diseaseHuman Immunodeficiency Virus

Identifiers

PMID34488812
PMCPMC8419948
OpenAlexW3198238104

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.