Hinojosa Carlos A, Nunez-Salgado Ana E, Anaya-Ayala Javier E, Laparra-Escareno Hugo, Ortiz-Lopez Laura J, Herrera-Caceres Jaime O, Crabtree-Ramirez Brenda E, Sierra-Madero Juan G
1 Department of Surgery, Section of Vascular Surgery and Endovascular Therapy, 42559 Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" , Mexico City, Mexico.
2 Department of Urology, 42559 Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" , Mexico City, Mexico.
Vascular. 2018 Oct;26(5):540-546. doi: 10.1177/1708538118770542. Epub 2018 Apr 13.
Objectives The longer survival of patients with human immunodeficiency virus/acquired immunodeficiency syndrome and the introduction of the highly active antiretroviral therapy have increased the number of chronic conditions; among these, cardiovascular diseases. The aim of this study is to determine patient, disease, and factors associated with peripheral arterial disease in a population of patients with human immunodeficiency virus/acquired immunodeficiency syndrome. Methods A prospective nested case-control study of a cohort of patients with human immunodeficiency virus/acquired immunodeficiency syndrome was conducted in a tertiary medical center in Mexico City. A sample size of 206 patients was calculated. Medical history, relevant laboratory data, peripheral arterial exam, and screening ankle-brachial index tests were obtained. Results The prevalence of abnormal ankle-brachial indexes was 20% (42 patients). Patient's mean age was 44 years ±13. The majority (98.5%) were actively receiving highly active antiretroviral therapy; active smoking was reported in 55 (27%), arterial hypertension and type 2 diabetes mellitus were found in 24 (12%) and 22 (11%) patients. Median time from the human immunodeficiency virus diagnosis was eight years (Interquartile range ±11); the mean CD4 count was 481, with a mean viral load of 13,557 copies (SD ± 69025.27) and 1889.18 (SD ± 9052.77) for patients with normal and abnormal ankle-brachial index and a median of 40 (IQ ± 2). Viral load ( p = 0.04) and number of years with human immunodeficiency virus/acquired immunodeficiency syndrome ( p = 0.04) were significantly associated with abnormal ankle-brachial indexes. Conclusions Abnormal ankle-brachial index seems to be more frequent in Mexican patients with human immunodeficiency virus/acquired immunodeficiency syndrome when compared with the general population at the same age. The most important factors associated with arterial disease were the viral load and the number of years with human immunodeficiency virus/acquired immunodeficiency syndrome.
ClinicalTrials.gov NCT02264509.
目的 人类免疫缺陷病毒/获得性免疫缺陷综合征患者生存期的延长以及高效抗逆转录病毒疗法的引入增加了慢性病的数量;其中包括心血管疾病。本研究的目的是确定人类免疫缺陷病毒/获得性免疫缺陷综合征患者群体中与外周动脉疾病相关的患者、疾病及因素。方法 在墨西哥城的一家三级医疗中心对一组人类免疫缺陷病毒/获得性免疫缺陷综合征患者进行前瞻性巢式病例对照研究。计算得出样本量为206例患者。获取了病史、相关实验室数据、外周动脉检查及踝臂指数筛查测试结果。结果 异常踝臂指数的患病率为20%(42例患者)。患者的平均年龄为44岁±13岁。大多数(98.5%)患者正在积极接受高效抗逆转录病毒疗法;55例(27%)患者有主动吸烟史,24例(12%)患者患有动脉高血压,22例(11%)患者患有2型糖尿病。自人类免疫缺陷病毒诊断后的中位时间为8年(四分位间距±11);正常和异常踝臂指数患者的平均CD4细胞计数分别为481,平均病毒载量分别为13557拷贝(标准差±69025.27)和1889.18(标准差±9052.77),中位数为40(四分位间距±2)。病毒载量(p = 0.04)和人类免疫缺陷病毒/获得性免疫缺陷综合征患病年限(p = 0.04)与异常踝臂指数显著相关。结论 与同年龄的普通人群相比,墨西哥人类免疫缺陷病毒/获得性免疫缺陷综合征患者中异常踝臂指数似乎更为常见。与动脉疾病相关的最重要因素是病毒载量和人类免疫缺陷病毒/获得性免疫缺陷综合征患病年限。
ClinicalTrials.gov NCT02264509