预测艾滋病毒感染者心血管风险使用PREVENT方程与聚合队列方程相比
Matthew S Durstenfeld1,2,3, Megan M McLaughlin4, Monica Gandhi4,5
1Department of Medicine, University of California San Francisco, San Francisco, USA. matthew.durstenfeld@ucsf.edu.
Journal of general internal medicine
|June 6, 2025
概括
新的PREVENT方程低估了艾滋病毒 (PWH) 感染者的动脉样硬化心血管疾病 (ASCVD) 风险,这可能导致更少的他类药物建议和更多的差异. 需要进一步的研究来完善对这一群体的风险预测.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
背景情况:
- 艾滋病毒感染者 (PWH) 面临更高的动脉样硬化心血管疾病 (ASCVD) 风险.
- 现有的风险计算器经常低估PWH的ASCVD风险.
- 美国心脏协会的PREVENT方程尚未在PWH中进行评估.
研究的目的:
- 在PWH中比较PREVENT和聚合队列方程 (PCE) 之间的10年ASCVD风险预测.
- 评估PREVENT对PWH的他类药物治疗建议的影响.
- 在PWH中确定ASCVD风险评估中的潜在差异.
主要方法:
- 使用现实世界的电子健康记录进行横截面观察研究.
- 包括40至75岁的PWH,没有先前存在的心血管疾病.
- 通过PREVENT和PCE预测的ASCVD风险进行比较,并根据当前的指导方针分析了他类药物的适用性.
主要成果:
- 在PWH中,PREVENT预测的10年ASCVD风险明显较低 (中位数为3.3%),相比PCE (中位数为7.7%).
- 97%的人使用PREVENT.有较低的预测风险.
- 达丁推从PCE的67.3%下降到PREVENT的28.6%,使用5%的ASCVD风险值.
结论:
- 与PCE相比,PREVENT方程低估了PWH中的ASCVD风险.
- 这种低估可能会导致建议使用他类药物的PWH减少58%,从而可能增加心血管疾病事件.
- 降低风险预测可能会加剧PWH之间的医疗保健差异.
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