Ebner Bertrand, Vincent Louis, Grant Jelani, Martinez Claudia
Department of Internal Medicine, Jackson Health System/University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Department of Cardiovascular Disease, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
J Cardiovasc Dev Dis. 2021 Mar 27;8(4):33. doi: 10.3390/jcdd8040033.
With the advent of effective antiretroviral therapies, there has been a decrease in HIV-related mortality, but an increase in non-AIDS-related comorbidities including cardiovascular disease (CVD). We sought to investigate current status of cardiac catheterization (CC) procedures in people with HIV (PWH). This is a retrospective study done at a University Hospital in South Florida between 2017 and 2019. Medical records from 985 PWH indicated that CC was performed in 1.9% of the cases. Of the PWH who underwent CC, 68% were found to have obstructive coronary artery disease (CAD). Among obstructive CAD cases, PCI was performed in 77% and CABG in 21% of cases; 26% had a repeat procedure and 11% died from non-cardiac causes. When comparing PWH who had CC to those who did not, there was a significantly higher rate of statin use (63% vs. 25%, < 0.015) and a higher prevalence of low ejection fraction (38% vs. 11%, = 0.004) among those patients who underwent CC. However, there was no significant difference in the prevalence of hypertension ( = 0.13), HbA1c levels ( = 0.32), CD4 count ( = 0.45) nor in undetectable viral load status ( = 0.75) after controlling for age, sex and BMI. Despite the finding of traditional CVD risk factors among PWH, there were no differences in HIV-related factors among patients requiring CC, supporting the importance of optimization of traditional CVD risk factors in this population.
随着有效抗逆转录病毒疗法的出现，与艾滋病相关的死亡率有所下降，但包括心血管疾病（CVD）在内的非艾滋病相关合并症有所增加。我们试图调查艾滋病毒感染者（PWH）心脏导管插入术（CC）的现状。这是一项在南佛罗里达一家大学医院于2017年至2019年进行的回顾性研究。985名PWH的病历显示，1.9%的病例进行了CC。在接受CC的PWH中，68%被发现患有阻塞性冠状动脉疾病（CAD）。在阻塞性CAD病例中，77%的病例进行了经皮冠状动脉介入治疗（PCI），21%的病例进行了冠状动脉旁路移植术（CABG）；26%进行了重复手术，11%死于非心脏原因。将接受CC的PWH与未接受CC的PWH进行比较时，接受CC的患者中他汀类药物的使用率显著更高（63%对25%，<0.015），低射血分数的患病率更高（38%对11%，=0.004）。然而，在控制年龄、性别和体重指数后，高血压患病率（=0.13）、糖化血红蛋白水平（=0.32）、CD4细胞计数（=0.45）以及病毒载量不可检测状态（=0.75）均无显著差异。尽管在PWH中发现了传统的CVD危险因素，但在需要CC的患者中，与艾滋病相关的因素没有差异，这支持了在该人群中优化传统CVD危险因素的重要性。
