Duke Global Health Institute, Durham, North Carolina, USA.
Kilimanjaro Christian Medical Centre, Moshi, TZ.
Glob Heart. 2022 Jun 10;17(1):38. doi: 10.5334/gh.1127. eCollection 2022.
HIV confers increased risk of myocardial infarction (MI), but there has been little study of ischemic electrocardiogram (ECG) findings among people with HIV in sub-Saharan Africa.
To compare the prevalence of ischemic ECG findings among Tanzanians with and without HIV and to identify correlates of ischemic ECG changes among Tanzanians with HIV.
Consecutive adults presenting for routine HIV care at a Tanzanian clinic were enrolled. Age- and sex-matched HIV-uninfected controls were enrolled from a nearby general clinic. All participants completed a standardized health questionnaire and underwent 12-lead resting ECG testing, which was adjudicated by independent physicians. Prior MI was defined as pathologic Q-waves in contiguous leads, and myocardial ischemia was defined as ST-segment depression or T-wave inversion in contiguous leads. Pearson's chi-squared test was used to compare the prevalence of ECG findings among those with and without HIV and multivariate logistic regression was performed to identify correlates of prior MI among all participants.
Of 497 participants with HIV and 497 without HIV, 272 (27.8%) were males and mean (sd) age was 45.2(12.0) years. ECG findings suggestive of prior MI (11.1% vs 2.4%, OR 4.97, 95% CI: 2.71-9.89, < 0.001), and myocardial ischemia (18.7% vs 12.1% OR 1.67, 95% CI: 1.18-2.39, = 0.004) were significantly more common among participants with HIV. On multivariate analysis, ECG findings suggestive of prior MI among all participants were associated with HIV infection (OR 4.73, 95% CI: 2.51-9.63, = 0.030) and self-reported family history of MI or stroke (OR 1.96, 95% CI: 1.08-3.46, = 0.023).
There may be a large burden of ischemic heart disease among adults with HIV in Tanzania, and ECG findings suggestive of coronary artery disease are significantly more common among Tanzanians with HIV than those without HIV.
HIV 会增加心肌梗死（MI）的风险，但在撒哈拉以南非洲地区，针对 HIV 感染者的缺血性心电图（ECG）结果研究甚少。
比较坦桑尼亚 HIV 感染者和非 HIV 感染者缺血性 ECG 结果的发生率，并确定 HIV 感染者缺血性 ECG 改变的相关因素。
连续纳入在坦桑尼亚诊所接受常规 HIV 护理的成年患者。从附近的普通诊所招募年龄和性别匹配的未感染 HIV 的对照组。所有参与者都完成了标准化的健康问卷，并接受了 12 导联静息 ECG 检查，由独立医生进行裁决。先前的 MI 定义为连续导联病理性 Q 波，心肌缺血定义为连续导联 ST 段压低或 T 波倒置。采用 Pearson's χ2 检验比较 HIV 感染者和非 HIV 感染者的 ECG 结果发生率，采用多变量逻辑回归分析所有参与者中先前 MI 的相关因素。
在 497 名 HIV 感染者和 497 名非 HIV 感染者中，272 名（27.8%）为男性，平均（标准差）年龄为 45.2（12.0）岁。心电图结果提示先前 MI（11.1% vs 2.4%，OR 4.97，95%CI：2.71-9.89， < 0.001）和心肌缺血（18.7% vs 12.1%，OR 1.67，95%CI：1.18-2.39， = 0.004）在 HIV 感染者中更为常见。多变量分析显示，所有参与者心电图结果提示先前 MI 与 HIV 感染相关（OR 4.73，95%CI：2.51-9.63， = 0.030）和自我报告的心肌梗死或中风家族史（OR 1.96，95%CI：1.08-3.46， = 0.023）。
在坦桑尼亚，HIV 感染者中可能存在大量缺血性心脏病负担，且心电图结果提示冠心病在 HIV 感染者中比非 HIV 感染者更为常见。
