An OR .1 suggests an advantage of CABG over PCI. ARTS1 indicates Arterial Revascularization Therapy Study I1033; BARI I, Bypass Angioplasty Revascularization Investigation I1005; CARDia, Coronary Artery Revascularization in Diabetes1176; CI, confidence interval; DM, diabetes mellitus; MASS II, Medicine, Angioplasty, or Surgery Study II1008; OR, odds ratio; SYNTAX, Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery; and W, weighted.1006 Fihn et al Stable Ischemic Heart Disease: Full Text e425 5.12.6. HIV Infection and SIHD HIV infection appears to be associated with an increased risk of premature coronary and cerebrovascular atherosclerosis, which is often accelerated, diffuse, and circumferential, involving whole arteries.1195,1196 AMI is often the initial manifestation.1197 The etiology is likely multifactorial and related to both the underlying infection and antiretroviral therapy. The former appears to promote proliferation of smooth muscle cells and elastin leading to luminal obstruc- tion, although there is poor correlation between CD4 cell counts and severity of CAD. Of the therapeutic agents used to treat HIV infection, protease inhibitors in particular have been epidemiologically linked to dyslipidemia and insulin resistance.1198 1200 The protease inhibitors amprenavir/fosam- prenavir with or without ritonavir and lopinavir with ritonavir have the strongest association with risk of AMI, although saquinavir and nelfinavir do not appear to be associated with MI.1201,1202 The nucleoside reverse-transcriptase inhibitors didanosine and abacavir also are associated with risk of AMI.1202 Other agents, such as nonnucleoside reverse- transcriptase inhibitors (nevirapine and efavirenz), entry in- hibitors, and integrase inhibitors, do not appear to be associ- ated with an increased risk of IHD. 