Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study
Renal Impairment and Cardiovascular Disease in HIV-Positive Individuals: The D:A:D Study
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DOI：
10.1093/infdis/jiw342
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发表时间：
2016-10-15
影响因子：
6.4
通讯作者：
Mocroft, Amanda
中科院分区：
文献类型：
--
作者：
Ryom, Lene;Lundgren, Jens D.;Mocroft, Amanda
背景虽然肾损害和心血管疾病（CVD）之间的关联在一般人群中已得到很好的确立，但对人类免疫缺陷病毒（HIV）阳性个体中的这种关联仍知之甚少。2004年2月1日之后，对肾小球滤过率（eGFR）估计值≥ 2的个体进行随访，直至CVD、死亡、末次访视加6个月或2015年2月1日。CVD定义为中心确认的心肌梗死、卒中、侵入性心血管操作或心脏性猝死的发生。在8.0年（四分位距，5.4-8.9年）的中位随访期间，35357例患者中有1357例发生CVD（发病率，5.2例/1000人-年[95%置信区间{CI}，5.0-5.5]）。经证实的基线eGFR和CVD密切相关，估计eGFR > 90 mL/min/1.73 m2的个体中有1.8%（95% CI，1.6%-2.0%）在5年时发生CVD，eGFR > 90 mL/min/1.73 m2的个体中有21.1%（95% CI，6.6%-35.6%）在5年时发生CVD。
Background. While the association between renal impairment and cardiovascular disease (CVD) is well established in the general population, the association remains poorly understood in human immunodeficiency virus (HIV)-positive individuals.Methods. Individuals with >= 2 estimated glomerular filtration rate (eGFR) measurements after 1 February 2004 were followed until CVD, death, last visit plus 6 months, or 1 February 2015. CVD was defined as the occurrence of centrally validated myocardial infarction, stroke, invasive cardiovascular procedures, or sudden cardiac death.Results. During a median follow-up duration of 8.0 years (interquartile range, 5.4-8.9 years) 1357 of 35 357 individuals developed CVD (incidence rate, 5.2 cases/1000 person-years [95% confidence interval {CI}, 5.0-5.5]). Confirmed baseline eGFR and CVD were closely related with 1.8% of individuals (95% CI, 1.6%-2.0%) with an eGFR > 90 mL/minute/1.73 m(2) estimated to develop CVD at 5 years, increasing to 21.1% (95% CI, 6.6%-35.6%) among those with an eGFR