Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts.
Memorial Cardiac and Vascular Institute, Hollywood, Florida.
Am J Cardiol. 2020 Jul 15;127:156-162. doi: 10.1016/j.amjcard.2020.04.019. Epub 2020 Apr 22.
Cardiovascular diseases (CVD) are more prevalent among HIV-infected subjects. We examined the associations between carotid artery intima-media thickness (CIMT), conventional CVD risk factors, and HIV-related risk factors among Hispanics with HIV infection. This cross-sectional study involved 96 consecutive HIV patients on stable antiretroviral therapy and without history of CVD in a university-based outpatient clinic who underwent carotid ultrasound evaluation. Increased CIMT was defined as common carotid artery-CIMT values greater than or equal to seventy-fifth percentile for the patient's age, sex, and race/ethnicity based on CIMT nomograms from large population studies. The sample was comprised of 96 Hispanic Americans aged 39.7 ± 11.9, 89% of whom were men, 64% were on a protease inhibitor, and 11% had increased CIMT (95% confidence intervals 5.9% to 19.6%). In univariable analysis, increased CIMT was significantly associated (p <0.05) with older age, metabolic syndrome, intermediate/high Framingham risk score, HIV infection duration ≥5 years, integrase inhibitors, and protease inhibitors. In multivariable analysis, only Framingham risk score (p = 0.009) was independently associated with increased CIMT. The median common carotid artery-CIMT value was significantly greater in patients with intermediate/high compared with those with low Framingham risk score (0.60 vs 0.49 mm; p <0.001). In conclusion, given the significant association between increased CIMT and Framingham risk score, adherence to prevention guidelines to reduce CVD risk factor burden in this population is strongly recommended.
心血管疾病（CVD）在 HIV 感染者中更为普遍。我们研究了颈动脉内膜中层厚度（CIMT）与传统 CVD 危险因素以及 HIV 相关危险因素之间的关系，这些危险因素存在于感染 HIV 的西班牙裔人群中。这是一项横断面研究，涉及在一所大学门诊接受过颈动脉超声评估的 96 名连续 HIV 患者，这些患者正在接受稳定的抗逆转录病毒治疗，并且没有 CVD 病史。CIMT 增加的定义是根据大型人群研究的 CIMT 图谱，患者的年龄、性别和种族/族裔的颈总动脉-CIMT 值大于或等于第 75 百分位。该样本由 96 名年龄为 39.7 ± 11.9 岁的西班牙裔美国人组成，其中 89%为男性，64%接受蛋白酶抑制剂治疗，11%有 CIMT 增加（95%置信区间为 5.9%至 19.6%）。在单变量分析中，CIMT 增加与年龄较大、代谢综合征、中等/高 Framingham 风险评分、HIV 感染持续时间≥5 年、整合酶抑制剂和蛋白酶抑制剂显著相关（p <0.05）。在多变量分析中，只有 Framingham 风险评分（p = 0.009）与 CIMT 增加独立相关。与 Framingham 风险评分低的患者相比，中等/高 Framingham 风险评分的患者颈总动脉-CIMT 值明显更高（0.60 毫米与 0.49 毫米；p <0.001）。总之，鉴于 CIMT 增加与 Framingham 风险评分之间存在显著关联，强烈建议在该人群中遵循预防指南以降低 CVD 危险因素负担。
