女性中的HIV感染与心血管疾病
HIV infection and cardiovascular disease in women.
作者信息
Womack Julie A, Chang Chung-Chou H, So-Armah Kaku A, Alcorn Charles, Baker Jason V, Brown Sheldon T, Budoff Matthew, Butt Adeel A, Gibert Cynthia, Goetz Matthew Bidwell, Gottdiener John, Gottlieb Stephen, Justice Amy C, Leaf David, McGinnis Kathleen, Rimland David, Rodriguez-Barradas Maria C, Sico Jason, Skanderson Melissa, Tindle Hilary, Tracy Russell P, Warner Alberta, Freiberg Matthew S
机构信息
Yale School of Nursing, West Haven, CT (J.A.W.).
University of Pittsburgh School of Medicine, Pittsburgh, PA (C.C.H.C., A.A.B., H.T.) University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA (C.C.H.C., C.A.).
出版信息
J Am Heart Assoc. 2014 Oct 16;3(5):e001035. doi: 10.1161/JAHA.114.001035.
BACKGROUND
HIV infection is associated with increased risk of cardiovascular disease (CVD) in men. Whether HIV is an independent risk factor for CVD in women has not yet been established.
METHODS AND RESULTS
We analyzed data from the Veterans Aging Cohort Study on 2187 women (32% HIV infected [HIV(+)]) who were free of CVD at baseline. Participants were followed from their first clinical encounter on or after April 01, 2003 until a CVD event, death, or the last follow-up date (December 31, 2009). The primary outcome was CVD (acute myocardial infarction [AMI], unstable angina, ischemic stroke, and heart failure). CVD events were defined using clinical data, International Classification of Diseases, Ninth Revision, Clinical Modification codes, and/or death certificate data. We used Cox proportional hazards models to assess the association between HIV and incident CVD, adjusting for age, race/ethnicity, lipids, smoking, blood pressure, diabetes, renal disease, obesity, hepatitis C, and substance use/abuse. Median follow-up time was 6.0 years. Mean age at baseline of HIV(+) and HIV uninfected (HIV(-)) women was 44.0 versus 43.2 years (P<0.05). Median time to CVD event was 3.1 versus 3.7 years (P=0.11). There were 86 incident CVD events (53%, HIV(+)): AMI, 13%; unstable angina, 8%; ischemic stroke, 22%; and heart failure, 57%. Incident CVD/1000 person-years was significantly higher among HIV(+) (13.5; 95% confidence interval [CI]=10.1, 18.1) than HIV(-) women (5.3; 95% CI=3.9, 7.3; P<0.001). HIV(+) women had an increased risk of CVD, compared to HIV(-) (hazard ratio=2.8; 95% CI=1.7, 4.6; P<0.001).
CONCLUSIONS
HIV is associated with an increased risk of CVD in women.
背景
男性感染HIV与心血管疾病（CVD）风险增加相关。HIV是否为女性CVD的独立危险因素尚未明确。
方法与结果
我们分析了退伍军人老龄化队列研究中2187名女性的数据，这些女性在基线时无CVD。从2003年4月1日或之后的首次临床就诊开始对参与者进行随访，直至发生CVD事件、死亡或最后随访日期（2009年12月31日）。主要结局为CVD（急性心肌梗死[AMI]、不稳定型心绞痛、缺血性中风和心力衰竭）。使用临床数据、国际疾病分类第九版临床修订版编码和/或死亡证明数据定义CVD事件。我们使用Cox比例风险模型评估HIV与新发CVD之间的关联，并对年龄、种族/族裔、血脂、吸烟、血压、糖尿病、肾病、肥胖、丙型肝炎和药物使用/滥用进行校正。中位随访时间为6.0年。HIV阳性（HIV(+)）和未感染HIV（HIV(-)）女性的基线平均年龄分别为44.0岁和43.2岁（P<0.05）。发生CVD事件的中位时间分别为3.1年和3.7年（P=0.11）。有86例新发CVD事件（53%为HIV(+)）：AMI占13%；不稳定型心绞痛占8%；缺血性中风占22%；心力衰竭占57%。HIV(+)女性的新发CVD/1000人年（13.5；95%置信区间[CI]=10.1，18.1）显著高于HIV(-)女性（5.3；95%CI=3.9，7.3；P<0.001）。与HIV(-)女性相比，HIV(+)女性发生CVD的风险增加（风险比=2.8；95%CI=1.7，4.6；P<0.001）。
结论
HIV与女性CVD风险增加相关。
Zotero 插件