Some Nucleoside Analogue Antiretrovirals Can Increase Risk for MI

Among antiviral agents for HIV, protease inhibitors (PIs) cause dyslipidemia and engender risk for myocardial infarction. Some studies have suggested that nucleoside reverse transcriptase inhibitors (NRTIs), generally used in combination with PIs, also contribute to MI risk. Two NRTIs in particular, the thymidine analogues zidovudine and stavudine, are suspects because of their associations with dyslipidemia and other cardiovascular risk factors.

To determine whether use of NRTIs is associated with MI risk, investigators analyzed data from a cohort of 33,347 HIV-positive patients; 517 of them experienced MIs. Risk for MI was not associated with cumulative use of any NRTI. However, recent use of abacavir or didanosine (but not zidovudine, sta…