患有艾滋病毒的人群的虚弱,皮塔瓦斯和主要心血管不良事件
Kristine M Erlandson1, Ariela R Orkaby2, Triin Umbleja3
1Department of Medicine, University of Colorado Denver- Anschutz Medical Campus, Aurora, Colorado, USA.
JACC. Advances
|August 21, 2025
概括
在艾滋病毒感染者 (PWH) 中,脆弱性显著增加了心血管风险. 皮塔瓦斯可以减少主要的心血管不良事件 (MACE),不论其是否脆弱,但其对脆弱个体的有效性需要进一步研究.
科学领域:
- 心血管医学
- 老年医学
- 传染病流行病学
背景情况:
- 患有艾滋病毒 (PWH) 的人面临动脉样硬化心血管疾病 (ASCVD) 和衰老症候群的风险增加.
- 在REPRIEVE试验中,皮塔瓦斯塔丁在PWH中减少了36%的重大心血管不良事件 (MACE),但其对脆弱个体的益处尚不清楚.
研究的目的:
- 确定虚弱是否与PWH中MACE风险增加有关.
- 评估皮塔瓦斯是否提供MACE预防的好处,不论其脆弱性状况如何.
主要方法:
- 在REPRIEVE随机试验中对7740名艾滋病毒感染者 (年龄在40至75岁之间) 进行了后期分析,但没有ASCVD.
- 使用32项脆弱性指数评估脆弱性,并根据脆弱性状态分析了考克斯比例危险模型的MACE风险.
- 评估皮塔瓦斯塔丁对MACE的影响是否因脆弱性而改变.
主要成果:
- 与脆弱性相比,MACE的危险性显著增加:在脆弱之前的1.76倍,在脆弱的个体中是2.14倍.
- 没有发现有意义的相互作用,表明皮塔瓦斯塔丁对MACE的影响不因脆弱性而异 (P=0. 44).
结论:
- 脆弱性是PWH中MACE的一个重要独立风险因素.
- 皮塔瓦斯塔丁似乎可以在脆弱的情况下提供心血管保护,但需要更多的数据来确认脆弱个体的小小组的有效性.
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