Statins to improve cardiovascular outcomes in treated HIV infection.
Statins to improve cardiovascular outcomes in treated HIV infection.
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DOI：
10.1097/qco.0000000000000223
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发表时间：
2016-02
影响因子：
3.9
通讯作者：
McComsey GA
中科院分区：
文献类型：
--
作者：
Longenecker CT;Eckard AR;McComsey GA
To evaluate evidence that statins reduce cardiovascular risk in patients living with HIV Moderate to high dose atorvastatin and rosuvastatin appear to reduce non-calcified coronary plaque volume and slow progression of carotid intima-media thickness in patients with treated HIV infection. Expected lipoprotein changes with statins on the background of modern ART are similar to the general population. In addition to lipids, the statin benefit may be mediated in part by improvements in vascular inflammation and levels of T-cell and monocyte activation. One concern is the potential for rosuvastatin to cause insulin resistance. Decisions to prescribe statins must be done in the context of global risk assessment, but traditional risk calculators such as the Framingham risk score or the ACC/AHA pooled-risk equations underestimate risk in this population. Furthermore, many patients with subclinical disease would not be recommended for statins according to the most recent ACC/AHA guidelines. Statins are likely to improve cardiovascular outcomes for patients with HIV, but results of the first outcome study are not expected until 2020. In the meantime, clinicians should individualize statin prescriptions, and should consider using more potent statins (rosuvastatin, atorvastatin, and pitavastatin) when possible.
