Department of Internal Medicine, Jacobi Medical Center, Bronx, New York, USA
Division of cardiology, Brown University Health, Providence, RI, USA.
BMJ Open. 2024 Oct 29;14(10):e085081. doi: 10.1136/bmjopen-2024-085081.
Studies have elucidated that heart failure (HF) in people living with HIV manifests differently when compared with HF cases in the general population. This cohort aimed to examine the mortality risk factors, including biological and social factors, as well as suitable medical interventions to prevent death in this population.
The New York City Health+Hospitals HIV Heart Failure (NYC4H) cohort encompassed records from 11 major hospital sites. Adult individuals with confirmed HIV and HF were recruited from either inpatient or clinic hospital visits between July 2017 and June 2022. The first follow-up period began on the date of the first clinical encounter until June 2023, and the second follow-up period extended between July 2022 and October 2023.
In total, 1044 patients were enrolled in the study. The cohort comprised 657 (62.9%) males and 387 (37.1%) females. The average age was 61.6 years at baseline and the average follow-up time was 3.8 years. Overall, a total of 259 (24.8%) deaths were identified, of which 193 occurred in the first follow-up period (enrolling date to June 2022) and 66 during the second follow-up period (June 2022 to October 2023). The most common comorbidities within this population were hypertension (75.3%), chronic obstructive pulmonary disease (39.2%), type II diabetes mellitus (40%) and hyperlipidaemia (35.7%). The most common social adversities were polysubstance use (31.13%), mental health-related issues (20.7%) and lack of family support (14.5%). 601 (57.6%) patients had encountered at least one and more than one social adversity in their lifetime.
Currently, nutritional notes from licensed dietitians and right and left heart catheterisation reports are under review. We are scheduled to complete the data collection for the comprehensive third follow-up period, which includes follow-up psychosocial evaluations, by the end of 2025. In addition, we intend to conduct annual follow-ups for specific high-risk groups, such as individuals with pulmonary hypertension, those facing higher social adversities and participants with poor HIV control.
研究表明，与普通人群中的心力衰竭（HF）病例相比，HIV 感染者的心力衰竭表现不同。本队列旨在研究死亡率的风险因素，包括生物学和社会因素，以及适合预防该人群死亡的医疗干预措施。
纽约市健康与医院 HIV 心力衰竭（NYC4H）队列包含了来自 11 个主要医院的记录。2017 年 7 月至 2022 年 6 月期间，从住院或门诊就诊的确诊 HIV 合并 HF 的成年患者中招募了参与者。第一个随访期从第一次临床就诊开始，持续到 2023 年 6 月，第二个随访期从 2022 年 7 月延长到 2023 年 10 月。
共有 1044 名患者入组本研究。队列由 657 名（62.9%）男性和 387 名（37.1%）女性组成。基线时的平均年龄为 61.6 岁，平均随访时间为 3.8 年。总体而言，共确定了 259 例（24.8%）死亡，其中 193 例发生在第一个随访期（入组日期至 2022 年 6 月），66 例发生在第二个随访期（2022 年 6 月至 2023 年 10 月）。该人群中最常见的合并症是高血压（75.3%）、慢性阻塞性肺疾病（39.2%）、2 型糖尿病（40%）和高脂血症（35.7%）。最常见的社会逆境是多物质使用（31.13%）、与心理健康相关的问题（20.7%）和缺乏家庭支持（14.5%）。601 名（57.6%）患者一生中至少经历过一次和多次社会逆境。
目前，正在审查持牌营养师的营养记录和左右心导管报告。我们计划在 2025 年底完成全面的第三次随访的所有数据收集，其中包括随访期间的社会心理评估。此外，我们还计划对特定的高危人群进行年度随访，例如患有肺动脉高压、面临更高社会逆境和 HIV 控制不佳的参与者。
