Tükenmez Tigen Elif, Gökengin Deniz, Özkan Özdemir Hülya, Akalın Halis, Kaya Bülent, Deveci Aydın, İnan Asuman, İnan Dilara, Altunsoy Adalet, Özel Ayşe Serra, Karaoğlan İlkay, Eraksoy Haluk, Demirdal Tuna, Yıldırmak Taner, Birengel Serhat, İnci Ayşe, Nazlı Arzu, Kayaaslan Bircan, Özan Köse Sevgi, Ataman Hatipoğlu Çiğdem, Esen Yasemin, Koç Tuba, Gilik Petek, Korten Volkan
Department of Infectious Diseases and Clinical Microbiology, Marmara University Hospital, İstanbul, Türkiye.
Department of Infectious Diseases and Clinical Microbiology, Ege University Hospital, İzmir, Türkiye.
Anatol J Cardiol. 2024 Oct 18;28(12):584-91. doi: 10.14744/AnatolJCardiol.2024.4558.
Cardiovascular disease (CVD) is a major cause of mortality among people living with HIV (PLWH). We aimed to assess the prevalence of diagnosed CVD and the risk of CVD among PLWH using 5 different tools.
This retrospective, cross-sectional study was conducted in 20 tertiary centers in Türkiye between October 2021 and March 2022, among 1425 PLWH aged 40-75 years. About 82.7% were male, with a median age of 51. Web-based tools for each score were used for CVD risk calculations.
Of 1425 PLWH enrolled, 10.8% had confirmed CVD, and 1132 had their risk scores evaluated. Of those participants, 42.8% had a higher risk of CVD (10-year risk of atherosclerotic CVD risk score (ASCVD) above 7.5%), and according to the European Society of Cardiology systemic coronary risk evaluation 2 (SCORE2), 71.7% had a high- to very high-risk rate. The agreement between various CVD risk tools varied, with Framingham heart study risk score (FRS), modified FRS, data collection on adverse effects of anti-HIV drugs (DAD), and SCORE2 for high-risk countries showing overall agreement rates of 82%, 94%, 91%, and 36%, respectively, compared to ASCVD. According to the 2021 European and 2019 American Cardiology guidelines, 75.3% and 47.1% of PLWH would be eligible for lipid-lowering agents, respectively.
The diagnosed CVD prevalence highlighted the importance of monitoring cardiovascular health and comorbidities in this population. SCORE2 identified a greater number of individuals at high/very high risk compared to other prediction tools. The implementation of CVD prevention through lipid-lowering therapy was far from desired levels in our cohort.
心血管疾病（CVD）是艾滋病毒感染者（PLWH）死亡的主要原因。我们旨在使用5种不同工具评估PLWH中已诊断CVD的患病率和CVD风险。
这项回顾性横断面研究于2021年10月至2022年3月在土耳其的20个三级中心进行，研究对象为1425名年龄在40 - 75岁的PLWH。约82.7%为男性，中位年龄为51岁。使用基于网络的工具计算每种评分的CVD风险。
在纳入的1425名PLWH中，10.8%确诊患有CVD，1132名参与者的风险评分得到评估。在这些参与者中，42.8%有较高的CVD风险（动脉粥样硬化性CVD风险评分（ASCVD）的10年风险高于7.5%），根据欧洲心脏病学会系统性冠状动脉风险评估2（SCORE2），71.7%有高至非常高的风险率。各种CVD风险工具之间的一致性各不相同，与ASCVD相比，弗雷明汉心脏研究风险评分（FRS）、改良FRS、抗逆转录病毒药物不良反应数据收集（DAD）以及高风险国家的SCORE2的总体一致率分别为82%、94%、91%和36%。根据2021年欧洲和2019年美国心脏病学指南，分别有75.3%和47.1%的PLWH符合使用降脂药物的条件。
已诊断的CVD患病率凸显了在该人群中监测心血管健康和合并症的重要性。与其他预测工具相比，SCORE2识别出更多高/非常高风险的个体。在我们的队列中，通过降脂治疗实施CVD预防远未达到理想水平。
