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Prevalence of cardiovascular diseases in HIV-infected outpatients: results from a prospective, multicenter cohort study.
- Source :
-
Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2013 Mar; Vol. 102 (3), pp. 203-13. Date of Electronic Publication: 2012 Nov 02. - Publication Year :
- 2013
-
Abstract
- Background: Recent studies suggest a rising rate of cardiovascular disease (CVD) in HIV-infected subjects. Although most countries have an aging HIV-infected population, there remains a lack of knowledge about associated cardiovascular diseases.<br />Methods: This ongoing prospective multicentre observational cohort study aims to elucidate CVD prevalence in HIV-infected outpatients by standardized non-invasive cardiovascular screening. Cardiovascular and coronary risk was calculated using Framingham risk scores.<br />Results: 803 HIV-infected subjects (mean age 44.2 years, female 16.6 %) were included. The prevalence of CVD in HIV-infected subjects was 10.1 % (95 % CI 8.0-12.2 %). Aging HIV-infected patients (≥45 years, N = 348) exhibited significantly increased rates of CVD, including an elevated frequency of coronary artery disease (7.5 vs. 1.8 %, p < 0.001), myocardial infarction (6.0 vs. 1.8 %, p = 0.002) and peripheral arterial diseases (4.6 vs. 1.5 %, p < 0.017). Furthermore, aging patients exhibited a higher rate of chronic heart failure (5.2 vs. 1.5 %, p < 0.001), predominantly of ischemic etiology. In multivariate analyses, age (OR 2.05 per decade, 95 % CI 1.64-2.56), smoking (OR 5.96 per decade, 95 % CI 2.31-15.38) and advanced symptomatic HIV infection (OR 2.60 per decade, 95 % CI 1.31-5.15), were significantly associated with the prevalence of CVD. Based on the 10-year cardiovascular risk estimation, a disproportionate increase in cardiac events has to be expected in aging HIV-infected subjects in the next decades (≥45 years/<45 years 16.4 vs. 4.2 %, p < 0.001).<br />Conclusion: CVD in aging HIV-infected population is an increasing medical challenge. In the era of antiretroviral therapy, prevention and diagnostic strategies are essential to reduce the prevalence of CVD in HIV-infected patients.
- Subjects :
- Adult
Cardiovascular Diseases diagnosis
Cardiovascular Diseases prevention & control
Chi-Square Distribution
Female
Germany epidemiology
HIV Infections diagnosis
HIV Infections drug therapy
Humans
Logistic Models
Male
Mass Screening
Middle Aged
Multivariate Analysis
Odds Ratio
Prevalence
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
Time Factors
Cardiovascular Diseases epidemiology
HIV Infections epidemiology
Outpatients statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1861-0692
- Volume :
- 102
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Clinical research in cardiology : official journal of the German Cardiac Society
- Publication Type :
- Academic Journal
- Accession number :
- 23117698
- Full Text :
- https://doi.org/10.1007/s00392-012-0519-0