Statin therapy and low-density lipoprotein cholesterol reduction in HIV-infected individuals after acute coronary syndrome: Results from the PACS-HIV lipids substudy - 18/04/17
, Joe Miantezila Basilua, MSc c, d , Murielle Mary-Krause, PhD c, d , Sylvie Lang, PhD a , Emmanuel Teiger, MD, PhD e , Philippe Gabriel Steg, MD f, g, h, i , Christian Funck-Brentano, MD, PhD j, k, l, m , Pierre-Marie Girard, MD, PhD n , Dominique Costagliola, PhD c, d , Ariel Cohen, MD, PhD a , Marguerite Guiguet, PhD c, d on behalf the PACS-HIV investigators (Prognosis of Acute Coronary Syndrome in HIV-infected patients)
Background |
Knowledge about lipid interventions in secondary prevention in HIV-infected individuals is limited; studies are sparse.
Methods |
A prospective observational multicenter study enrolled 282 patients on statin 1 month after first acute coronary syndrome (ACS) (95 HIV-infected individuals, 187 HIV-uninfected). Data on fasting lipids (total cholesterol [TC], low-density lipoprotein cholesterol, high-density lipoprotein cholesterol [HDL-C], non–HDL-C, triglycerides, TC/HDL-C ratio) were collected over 3 years. The evolution of lipid concentrations was analyzed using mixed-effects models. Achievement of National Cholesterol Education Program Adult Treatment Panel III lipid goals and prescribed statin intensity was assessed.
Results |
Mean age of patients was 49.0 years, and 94% were men. Baseline lipids were similar in the 2 groups. Six months after first ACS, less low-density lipoprotein cholesterol reduction was observed in the HIV-infected GROUP (adjusted mean change −10.13; 95% CI −20.63 to 0.37; P=.06) than in the HIV-uninfected group (Adjusted mean change −38.51; 95% CI −46.00 to −31.04; P<.0001) Similar trends were observed for TC and non–HDL-C. After ACS, initial statin prescription for HIV-infected compared with HIV-uninfected individuals was more frequently a moderate-intensity statin (66% vs 45%) and less frequently a high-intensity statin (15% vs 45%). Over 3 years of follow-up, the proportion of HIV-infected patients receiving high-intensity statin remained persistently lower than the proportion observed in the HIV-uninfected group.
Conclusions |
In this observational study, HIV-infected individuals after first ACS exhibited worse lipid profiles than controls particularly during the first 6 months while receiving less potent statins. Appropriate statin intensity should be prescribed in HIV-infected individuals with awareness of potential drug-drug interactions.
Le texte complet de cet article est disponible en PDF.Plan
| Funding: This study was funded by the Agence Nationale de Recherche sur le Sida et les Hepatites Virales (French National Agency for Research on AIDS and Viral Hepatitis) and Sidaction-Ensemble contre le SIDA, Paris, France. |
|
| Clinical Trials.gov identifier NCT00139958. |
Vol 183
P. 91-101 - janvier 2017 Retour au numéro
Article précédent
- Effects of exercise and stress management training on nighttime blood pressure dipping in patients with coronary heart disease: A randomized, controlled trial
- Andrew Sherwood, Patrick J. Smith, Alan L. Hinderliter, Anastasia Georgiades, James A. Blumenthal
- Bendopnea and risk of adverse clinical outcomes in ambulatory patients with systolic heart failure
- Jennifer T. Thibodeau, Benjamin E. Jenny, Jeomi O. Maduka, Punag H. Divanji, Colby R. Ayers, Faris Araj, Alpesh A. Amin, Robert M. Morlend, Pradeep P.A. Mammen, Mark H. Drazner
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?