Bagchi Shashwatee, Burrowes Shana Ab, Fantry Lori E, Hossain Mian B, Tollera Gemechis H, Kottilil Shyamasundaran, Pauza C David, Miller Michael, Baumgarten Mona, Redfield Robert R
Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD, USA.
SAGE Open Med. 2017 Aug 10;5:2050312117725644. doi: 10.1177/2050312117725644. eCollection 2017.
To determine factors associated with increased risk of developing cardiovascular disease in a high-risk patient population.
Cross-sectional analysis of a retrospective cohort study.
One-hundred patients at an inner city HIV clinic in 2008 were reviewed. The atherosclerotic vascular disease risk score was calculated using the Pooled Cohort Equation. Chi-square test was performed to identify associations of potential risk factors with elevated atherosclerotic vascular disease risk.
Eighty-one participants were included in the final analysis. In total, 95.1% were African American, and 38.3% were women. The median atherosclerotic vascular disease risk score was 8.8% and 8.1% in 2008 and 2012, respectively. The medical co-morbidities associated with increased atherosclerotic vascular disease risk were hepatitis C infection (X = 3.93; p value = 0.048), elevated triglycerides levels (X = 4.0; p value = 0.046), and low albumin (X = 4.65; p value = 0.031). There were a higher number of women with known atherosclerotic vascular disease despite lower median atherosclerotic vascular disease risk score compared to men.
An elevated risk of developing cardiovascular disease persists in high-risk demographic groups of the HIV epidemic even in the current HIV era. There is an unexplained gender disparity and some non-traditional risk factors not accounted for in the Pooled Cohort Equation may be contributing to the excess cardiovascular disease risk observed among HIV-infected patients.
确定高危患者群体中与心血管疾病发生风险增加相关的因素。
回顾性队列研究的横断面分析。
对2008年一家市中心HIV诊所的100名患者进行了回顾。使用合并队列方程计算动脉粥样硬化性血管疾病风险评分。进行卡方检验以确定潜在风险因素与动脉粥样硬化性血管疾病风险升高之间的关联。
81名参与者纳入最终分析。总体而言,95.1%为非裔美国人,38.3%为女性。2008年和2012年动脉粥样硬化性血管疾病风险评分中位数分别为8.8%和8.1%。与动脉粥样硬化性血管疾病风险增加相关的合并症为丙型肝炎感染(X = 3.93;p值 = 0.048)、甘油三酯水平升高(X = 4.0;p值 = 0.046)和低白蛋白(X = 4.65;p值 = 0.031)。尽管动脉粥样硬化性血管疾病风险评分中位数低于男性,但已知患有动脉粥样硬化性血管疾病的女性人数较多。
即使在当前的HIV时代,HIV流行的高危人群中发生心血管疾病的风险仍然很高。存在无法解释的性别差异,合并队列方程未考虑的一些非传统风险因素可能导致了HIV感染患者中观察到的额外心血管疾病风险。