Cibrián-Ponce Angelica, Sánchez-Alemán Miguel A, García-Jiménez Sara, Pérez-Martínez Eduardo, Bernal-Fernández Germán, Castañon-Mayo Miguel, Ávila-Jiménez Laura, Toledano-Jaimes Cairo D
Faculty of Pharmacy, University of Morelos, Cuernavaca, Morelos, Mexico,
Center for Infectious Diseases Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
Ther Clin Risk Manag. 2018 Sep 25;14:1757-1764. doi: 10.2147/TCRM.S170536. eCollection 2018.
The third report of the National Cholesterol Education Program guidelines recommends calculating the 10-year morbidity of atherosclerotic cardiovascular disease (ASCVD) using risk calculators when treating high blood cholesterol in adults. We analyzed the changes in cardiovascular risk (CVR) among Mexican patients with HIV.
This observational, prospective cohort study compared the CVR after 1 year of antiretroviral treatment among 460 HIV patients from a Mexican clinic. Changes using the ASCVD risk estimator and changes in clinical outcomes were analyzed. The results were categorized as low or high CVR using a cutoff of 7.5%.
The CVR initially had a median of 2.3% (interquartile range [IQR]: 1%-4.8%), which changed to 2.4% (IQR: 1.5%-5.5%) after 1 year (=0.001). After CVR stratification, we found that 84.3% of the patients had a low CVR, and 18% in this subgroup had metabolic syndrome (MS). Moreover, 15.7% had high CVR, and 47% in this subgroup had MS. The 4.3% of patients had an increase in CVR from the low to high subgroup, and 2.6% had a decrease in CVR from the high to low subgroup. Out of all patients, 22.3% had MS.
More than 50% of the population had an increase in CVR after 1 year. Of these patients, 4.3% changed from the low to high CVR group. Although the guidelines proposed different time periods for performing CVR estimations, this study showed that such assessments offered valuable clinical data over a relatively short-term period.
美国国家胆固醇教育计划指南第三次报告建议，在治疗成人高胆固醇血症时，使用风险计算器计算动脉粥样硬化性心血管疾病（ASCVD）的10年发病风险。我们分析了墨西哥HIV患者心血管风险（CVR）的变化。
这项观察性前瞻性队列研究比较了墨西哥一家诊所460例HIV患者接受抗逆转录病毒治疗1年后的CVR。分析了使用ASCVD风险评估器得出的变化以及临床结局的变化。使用7.5%的临界值将结果分为低CVR或高CVR。
CVR初始中位数为2.3%（四分位间距[IQR]：1%-4.8%），1年后变为2.4%（IQR：1.5%-5.5%）（=0.001）。CVR分层后，我们发现84.3%的患者CVR较低，该亚组中18%患有代谢综合征（MS）。此外，15.7%的患者CVR较高，该亚组中47%患有MS。4.3%的患者CVR从低亚组升至高亚组，2.6%的患者CVR从高亚组降至低亚组。所有患者中，22.3%患有MS。
超过50%的人群在1年后CVR升高。在这些患者中，4.3%从低CVR组变为高CVR组。尽管指南提出了进行CVR评估的不同时间段，但本研究表明，此类评估在相对短期内可提供有价值的临床数据。
