Department of Dermatology and Venerology, University Hospital Essen, University of Duisburg-Essen, Medical School, Hufelandstr. 55, 45122, Essen, Germany.
Clin Res Cardiol. 2013 Mar;102(3):203-13. doi: 10.1007/s00392-012-0519-0. Epub 2012 Nov 2.
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.
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.
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).
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.
最近的研究表明，艾滋病毒感染者中心血管疾病（CVD）的发病率正在上升。尽管大多数国家的艾滋病毒感染者人口都在老龄化，但人们对相关心血管疾病的了解仍然有限。
本研究是一项正在进行的前瞻性多中心观察队列研究，旨在通过标准化的非侵入性心血管筛查来阐明艾滋病毒门诊患者的 CVD 患病率。使用 Framingham 风险评分计算心血管和冠状动脉风险。
共纳入 803 名艾滋病毒感染者（平均年龄 44.2 岁，女性占 16.6%）。艾滋病毒感染者的 CVD 患病率为 10.1%（95%CI8.0-12.2%）。年龄较大的艾滋病毒感染者（≥45 岁，N=348）CVD 发生率显著增加，包括冠心病（7.5%比 1.8%，p<0.001）、心肌梗死（6.0%比 1.8%，p=0.002）和外周动脉疾病（4.6%比 1.5%，p<0.017）的频率升高。此外，年龄较大的患者慢性心力衰竭（5.2%比 1.5%，p<0.001）的发生率更高，主要是缺血性病因。多变量分析显示，年龄（每十年增加 2.05，95%CI1.64-2.56）、吸烟（每十年增加 5.96，95%CI2.31-15.38）和晚期有症状的 HIV 感染（每十年增加 2.60，95%CI1.31-5.15）与 CVD 的患病率显著相关。基于 10 年心血管风险估计，未来几十年年龄较大的艾滋病毒感染者（≥45 岁/<45 岁）中心脏事件的比例预计会不成比例地增加（16.4%比 4.2%，p<0.001）。
老龄化艾滋病毒感染者人群中的 CVD 是一个日益严峻的医学挑战。在抗逆转录病毒治疗时代，预防和诊断策略对于降低艾滋病毒感染者 CVD 的患病率至关重要。
