艾滋病毒延迟呈现的心血管事件:前性PISCIS队列研究
Raquel Martín-Iguacel1,2, Mari Carmen Vazquez-Friol3, Joaquin Burgos4
1Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.
Frontiers in medicine
|July 7, 2023
概括
晚期艾滋病毒呈现者 (LP) 在开始抗逆转录病毒治疗 (ART) 后,与早期呈现者相比,心血管事件 (CVEs) 的长期风险并不高. 然而,识别传统的心血管风险因素对于降低艾滋病毒感染者心血管疾病 (CVD) 风险至关重要.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 与一般人群相比,艾滋病毒感染者 (PWH) 面临心血管疾病 (CVD) 的风险较高.
- 晚期艾滋病毒呈现者 (LP; CD4 计数 ≤ 350 细胞/μL 在诊断时) 和早期呈现者之间的心血管疾病风险的比较仍然不清楚.
研究的目的:
- 评估LP与非LP开始抗逆转录病毒治疗 (ART) 后心血管事件 (CVEs) 的发生率.
- 为了比较LP和非LP之间的第一个CVE后的全因死亡率.
主要方法:
- 未来的,多中心的PISCIS队列研究,包括3,317个PWH启动ART (2005-2019).
- 主要结局:第一个CVE的发生率 (缺血性心脏病,充血性心力衰竭,脑血管或外周血管疾病).
- 对共变量进行调整的普森回归分析.
主要成果:
- 在对混因子进行调整后,在LP和非LP之间没有观察到长期CVE风险的显著差异 (CD4<200的aIRR为0.92,CD4200-350的aIRR为0.84).
- 总体死亡率在LP中较高 (8.5%) 与非LP (2.3%) 相比 (p < 0.001).
- CVE后的死亡率在各组之间没有差异 (aMRR 1.24),但在女性,MSM和慢性肺/肝病患者中较高.
结论:
- 没有先前心血管疾病的晚期艾滋病毒呈现者与ART启动后的早期呈现者相比,没有显示CVE的长期风险增加.
- 专注于传统的心血管风险因素对于减轻艾滋病毒感染者心血管疾病风险至关重要.
- 在LP中总体死亡率较高,凸显了及时诊断和治疗艾滋病毒的重要性.
相关概念视频
Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation
17
Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
17
Coronary Artery Disease III: Clinical Manifestations
13
Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
13
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
38
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
38
Ischemic Heart Disease: Overview
1.3K
Ischemic heart disease occurs when the heart's blood supply dwindles, causing an ominous lack of oxygen and nutrients. This deficiency, stemming from reduced or obstructed blood flow, spells danger, leading to heart muscle damage and dysfunction.
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
1.3K
Psychoneuroimmunology: Cardiovascular Disease
54
Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
A key area of focus in PNI is the relationship between stress and coronary...
A key area of focus in PNI is the relationship between stress and coronary...
54
Acute Coronary Syndrome III: Diagnostic Studies
10
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
10


