Rerkasem Amaraporn, Tangmunkongvorakul Arunrat, Aurpibul Linda, Sripan Patumrat, Parklak Wason, Nantakool Sothida, Srithanaviboonchai Kriengkrai, Rerkasem Kittipan
Environmental-Occupational Health Sciences and Non Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
AIDS Care. 2023 Apr;35(4):591-599. doi: 10.1080/09540121.2022.2029820. Epub 2022 May 1.
Increased arterial stiffness is an indicator of cardiovascular disease (CVD) and death in the general population. The cardio-ankle vascular index (CAVI) is a novel method for measuring arterial stiffness. This study investigated the utility of CAVI as a prognostic indicator of CVD and death in older adults living with HIV(OALHIV). Patients aged ≥50 taking antiretroviral treatment with no history of cardiovascular events enrolled from multiple centers in Chiang Mai, Thailand. Participants ( = 347) who underwent CAVI were followed up for five years. The primary endpoint was major adverse cardiovascular events (MACE): a composite of total deaths and hospitalizations due to myocardial infarction, coronary revascularization, stroke, and heart failure. Cox regression analysis determined between normal (<8) and high (≥8) CAVI against the incidence of MACE. Forty-five participants (13.0%) were diagnosed with MACE. The risk of MACE was more significant in high CAVI than normal CAVI (adjusted HR = 2.11, 95% confidence interval 1.06-4.20, = 0.033). In OALHIV, CAVI was an independent prognosis of MACE, in addition to conventional CVD risk factors. CAVI-assisted to help identify high-risk patients showed the benefit of further evaluation and more intensive therapy to prevent CVD and death.
动脉僵硬度增加是一般人群心血管疾病（CVD）和死亡的一个指标。心踝血管指数（CAVI）是一种测量动脉僵硬度的新方法。本研究调查了CAVI作为老年HIV感染者（OALHIV）CVD和死亡预后指标的效用。从泰国清迈的多个中心招募年龄≥50岁、接受抗逆转录病毒治疗且无心血管事件病史的患者。对347名接受CAVI检测的参与者进行了为期五年的随访。主要终点是主要不良心血管事件（MACE）：包括全因死亡以及因心肌梗死、冠状动脉血运重建、中风和心力衰竭住院的综合情况。Cox回归分析确定了正常（<8）和高（≥8）CAVI与MACE发生率之间的关系。45名参与者（13.0%）被诊断为MACE。高CAVI组发生MACE的风险比正常CAVI组更显著（调整后HR = 2.11，95%置信区间1.06 - 4.20，P = 0.033）。在OALHIV中，除了传统的CVD危险因素外，CAVI是MACE的独立预后指标。CAVI有助于识别高危患者，显示出进一步评估和更强化治疗以预防CVD和死亡的益处。
