Is there continued evidence for an association between abacavir usage and myocardial infarction risk in individuals with HIV? A cohort collaboration. BMC Medicine
Sabin et al. for the D:A:D Study Group investigated whether the association between abacavir (ABC) and myocardial infarction (MI) remained present in data collected after 2008, when ABC was less likely to be prescribed to those at high cardiovascular disease (CVD) risk than before 2008. Overall, the rate of MI was 0.47/100 person-years (PYRS) among those currently receiving ABC and 0.21/100 PYRS among those not currently receiving ABC. After adjustment for potential confounders, current ABC use was associated with a 98 % increase in MI rate (adjusted rate ratio 1.98), with no difference in the pre- (1.97) and post- (1.97) March 2008 periods. Results were unchanged after stratifying by Framingham risk group, or after further adjusting for factors potentially on the causal pathway.
The study-results strongly suggest that the finding of a raised risk of MI for people on ABC is not explained by channelling of people with high CVD risk onto the drug.