TABLE OF CONTENTS Risk of myocardial infarction

Prolonged use of antiretroviral agents has been shown to reduce morbidity and mortality associated with human immunodeficiency virus (HIV) infection. However, the long term use of antiretroviral agents can result in adverse metabolic effects, including hyperlipidemia, insulin resistance, and diabetes. All of these metabolic consequences are risk factors for coronary artery disease and myocardial infarction. To determine the risks of heart disease with antiretroviral therapy, the Data Collection on Adverse Events of Anti-HIV Drugs (DAD) study was initiated in 1999. Specifically, the primary goal of the DAD study was to assess the effects of antiretroviral therapy on the risk of myocardial infarction. The DAD study was comprised of 11 established cohorts, with a total of 23,468 patients with HIV infection. Data were collected at 8-month intervals beginning in 1999 and included information on myocardial infarction, antiretroviral therapy, and cardiovascular risk factors.