Identifying HIV patients with an unfavorable cardiovascular risk profile in the clinical practice: Results from the SIMONE study - 08/08/11
for the CISAI study group
Summary |
Objective |
To identify and characterize HIV-infected patients at higher cardiovascular risk in ordinary clinical settings.
Design |
Multicenter, nationwide cross-sectional study.
Methods |
Consecutive HIV-patients, attending scheduled visits at facilities involved in the Italian coordination group for the study of allergies and HIV infection (CISAI), were included between February and April, 2005. Their 10-year probability of acute coronary events was calculated using the Framingham Risk Score (FRS) as well as 3 other cardiovascular algorithms (“PROCAM”, “PROGETTO CUORE”, “SCORE”); Metabolic Syndrome (MS) was diagnosed according to the National Cholesterol Education Program definitions. An estimated 10-year CVD ≥10% and/or MS led to the diagnosis of high CV risk. We compared selected clinical features between high- and low-risk patients.
Results |
A total of 1230 HIV infected patients (72% males, mean age of 43±9years), 185 of whom treatment-naïve, were evaluated. FRS gave the highest estimate of CV risk. The mean 10-year risk for acute coronary events according to FRS was 7.4±7.0. MS was present in 22% of the observed patients. Accordingly, 443 patients (36%) were classified at high risk. Twelve percent of the patients (n=142) had both a FRS ≥10% and a diagnosis of MS. The main single predictor of increased cardiovascular risk was smoking (60% of whole sample). A higher prevalence of clinically evident lipodystrophy and a higher CD4 T-cell counts were found both in patients with higher FRS and in patients with high FRS and MS (both p<0.001).
Conclusions |
The worst estimation of CV risk was obtained with the FRS algorithm. Clinical evidence of lipodystrophy and higher CD4 T-cell counts were closely associated to a worse cardiovascular risk profile.
Le texte complet de cet article est disponible en PDF.Keywords : Antiretroviral therapy, HIV, Metabolic Syndrome, Framingham Risk Score, Cardiovascular disease, Lipodystrophy, Arteriosclerosis
Plan
Vol 57 - N° 1
P. 33-40 - juillet 2008 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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