Smoking and Type 1 Versus Type 2 Myocardial Infarction Among People With HIV in the United States: Results from the Center for AIDS Research Network Integrated Clinical Systems Cohort.
Heidi M Crane, Robin M Nance, Stephanie A Ruderman and 24 others
PMID 39241219WHAT IT FOUND
Among people with HIV, current smoking was associated with higher type 1 MI risk, but not type 2 MI risk.
Pack-years captured smoking slightly better than status, and patient-reported questions performed better than chart diagnosis.
Key findings
01Current smoking was associated with higher type 1 MI risk (HR 1.84, 95% CI 1.33-2.55), while former smoking was not (HR 1.02, 95% CI 0.69-1.50).
02Current smoking was not significantly associated with type 2 MI (HR 1.43, 95% CI 0.99-2.08), though longer duration was associated with a 21% higher risk for every 10 years.
03For every 10 pack-years of smoking, type 1 MI risk increased by 30%, and pack-years gave the best model fit.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an observational cohort, so it shows association but cannot prove smoking caused MI. Smoking was self-reported on touchscreens, which may underestimate smoking compared with cotinine testing. The study did not measure secondhand smoke, occupational smoke, or other smoke exposures. Only 346 people had an MI, and type 4 and 5 MI were too few to analyze. Other smoking-related behaviors, such as drug use, could contribute, although sensitivity analyses adjusting for drug and alcohol use were similar. Findings apply to people with HIV in care at U.S. CNICS sites, not necessarily to all people with HIV.
Declared interests
No author conflicts of interest declaration is included in the supplied text. The article is listed as NIH extramural research support.
The easy way to misread this
Do not conclude that smoking caused type 1 MI or that quitting was shown to reduce risk. This observational study did not test a cessation intervention, and it cannot rule out other smoking-related behaviors as contributing factors.