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Abacavir Use and Risk for Myocardial Infarction in the NA-ACCORD
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Reported by Jules Levin
CROI 2015 Fe 23-26, Seattle, WA
Frank J. Palella Jr1, , Keri N. Althoff2, Richard D. Moore2, Jinbing Zhang2, Mari Kitahata3, Stephen Gange2, Heidi M Crane3, Dan Drozd3, John T .Brooks4, and Richard Elion 5
for the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of IeDEA
1Northwestern University Feinberg School of Medicine, Chicago, IL; 2Johns Hopkins University, Baltimore, MD; 3University of Washington, Division of Infectious Diseases, Seattle, WA;
4Centers for Disease Control and Prevention, Atlanta, GA, 5George Washington University, Washington, DC
from Jules: I spoke with authors at poster, Frank Palella gets the 2015 Oscar for the best performance at a poster. Still, in speaking with author they said with this analysis they did they best they could, but you can't eliminate all confounders and if you look at Figure 2 below the risk/statistical significance is not that much, very close to crossing the statistical significance line in the restricted population analysis, and does cross the line in the full population analysis, I don't think the results are convincing. They adjusted for many factors including renal impairment but its hard if not impossible to fully adjust for all confounders, there have been numerous analyses finding conflicting results.
The D:A:D replication model was adjusted for cumulative ABC exposure, age, sex, race, HIV transmission risk, calendar year,
BMI, cigarette smoking, years since HAART initiation and cohort.
Participants in the Full study population model included ABC naïve and treatment-experience adults. The model was adjusted
for age, sex, race, HIV transmission risk, calendar year, cigarette smoking, hypertension, diabetes, renal impairment, high total
cholesterol, high triglycerides, statin use, CD4 count, HIV viral load, previous PI use, and cohort, all measured prior to, or at the
time of study entry (which was ABC initiation for ABC users).
Participants in the Restricted study population model included HAART initiators. The model was adjusted for age, sex, race,
HIV transmission risk, calendar year, cigarette smoking, hepatitis C infection, hypertension, diabetes mellitus, renal impairment,
high total cholesterol, high triglycerides, statin use, CD4 cell count, HIV RNA, history of clinical AIDS diagnosis, previous PI use,
and cohort.
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