Statins and Aspirin use in HIV-infected people: gap between European AIDS Clinical Society guidelines and clinical practice: the results from HIV-HY study
Statins and Aspirin use in HIV-infected people: gap between European AIDS Clinical Society guidelines and clinical practice: the results from HIV-HY study
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DOI：
10.1007/s15010-016-0893-z
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发表时间：
2016-10-01
期刊：
影响因子：
7.5
通讯作者：
Bonfanti, Paolo
中科院分区：
文献类型：
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作者：
De Socio, Giuseppe Vittorio;Ricci, Elena;Bonfanti, Paolo
目的 调查他汀类药物和乙酰水杨酸 (ASA) 在 HIV 患者中的临床实践使用情况。 设计 进行了一项多中心、全国性、前瞻性队列研究，包括 1182 名连续的 HIV 患者。 方法 根据欧洲艾滋病临床学会 (EACS) 指南，对他汀类药物和 ASA 处方在一级和二级心血管疾病预防中的作用进行评估。 结果 随访患者 (998 例) 大部分为男性 (70.9%)，入组时的平均年龄为46.5 岁（SD 9.5）。平均随访时间为 3.3 年 (SD 0.8)。在最后一次随访时，EACS 指南建议 31.2% 的患者使用他汀类药物，16% 的患者建议使用 ASA。相反，只有 15.6% 和 7.6% 的患者分别接受他汀类药物和 ASA 治疗；在接受他汀类药物治疗的患者中，只有 50.3% 的患者达到了推荐的低密度脂蛋白胆固醇 (LDL-c) 水平。在最后一次随访时，他汀类药物治疗与 EACS 推荐之间的一致性为 0.58 (95% CI 0.52-0.63)。 ASA 治疗的相应数字为 0.50 (95% CI 0.42-0.58)，而 ASA 治疗在二级预防中的一致性为 0.59 (95% CI 0.50-0.68)。结论 HIV 感染患者中他汀类药物和 ASA 的处方在很大程度上仍然不够理想，因为只有约 50% 需要他汀类药物和 ASA 的患者得到了适当的治疗。对于这一高危人群，有必要对这一相关问题给予更多关注并进行进一步调查。
Objectives To investigate the use of statins and acetylsalicylic acid (ASA) in HIV people in clinical practice.Design A multicenter, nationwide, prospective cohort study, including 1182 consecutive HIV patients was conducted.Methods Statin and ASA prescription was evaluated in primary and secondary cardiovascular disease prevention, according to the European AIDS Clinical Society (EACS) guidelines.Results Followed-up patients (998) were mostly males (70.9 %) with a mean age at enrolment of 46.5 years (SD 9.5). The mean time of follow-up was 3.3 years (SD 0.8). At the last follow-up visit, statins would have been recommended for 31.2 % and ASA for 16 % by EACS guidelines. Conversely, only 15.6 and 7.6 % of patients were on statin and ASA treatment, respectively; only 50.3 % of patients treated with statins achieved recommended low-density lipoprotein cholesterol (LDL-c) levels. At the last follow-up visit, agreement between statin therapy and EACS recommendation was 0.58 (95 % CI 0.52-0.63). The corresponding figure for ASA therapy was 0.50 (95 % CI 0.42-0.58), whereas the agreement for ASA therapy in secondary prevention was 0.59 (95 % CI 0.50-0.68).Conclusions The prescription of statins and ASA in HIV-infected patients remains largely suboptimal, as only about 50 % of patients requiring statins and ASA are properly treated. Higher attention on this relevant issue and further investigation are warranted in this at risk population.