Heart Failure Outcomes and Associated Factors Among Veterans With Human Immunodeficiency Virus Infection.
Heart Failure Outcomes and Associated Factors Among Veterans With Human Immunodeficiency Virus Infection.
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DOI：
10.1016/j.jchf.2019.12.007
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发表时间：
2020-06
影响因子：
13
通讯作者：
Wu, Wen-Chih
中科院分区：
文献类型：
--
作者：
Erqou, Sebhat;Jiang, Lan;Choudhary, Gaurav;Lally, Michelle;Bloomfield, Gerald S.;Zullo, Andrew R.;Shireman, Theresa, I;Freiberg, Mathew;Justice, Amy C.;Rudolph, James;Lin, Nina;Wu, Wen-Chih
本研究旨在调查感染人类免疫缺陷病毒（HIV）的退伍军人心力衰竭（HF）的结果。关于人类免疫缺陷病毒 (PLHIV) 感染者心力衰竭结果的数据有限。我们对退伍军人健康事务数据进行了一项回顾性队列研究，以调查艾滋病毒感染者心力衰竭的结果。我们确定了 2000 年至 2018 年间诊断为心力衰竭的 5,747 名 HIV+ 退伍军人，并纳入了 33,497 名 HIV- 频率匹配的对照者。临床结果包括全因死亡率、心衰住院和全因住院。与患有心衰的 HIV-退伍军人相比，患有心衰的 HIV+退伍军人更有可能是黑人（56% vs. 14%）、吸烟者（52% vs. 29%）、饮酒（32% vs. 13%）或吸毒（37% vs. 8%），并且有更高的合并症负担（Elixhauser 合并症指数 5.1 vs. 2.6）。 HIV+ 和 HIV− 退伍军人的平均射血分数 (EF) (45 ± 16%) 相当。患有心力衰竭的 HIV+ 退伍军人的年龄、性别和种族调整后的 1 年全因死亡率（30.7% 比 20.3%）、心力衰竭入院率（21.2% 比 18.0%）和全因入院率（50.2% 比 38.5%）更高。在患有 HIV 和 HF 的退伍军人中，CD4 计数低（<200 个细胞/ml）和 HIV 病毒载量高（>75 拷贝/μl）的人预后较差。在调整大量协变量后，这些关联在统计上仍然显着。射血分数 <45% 的 HIV+ 退伍军人的全因死亡率和心力衰竭入院率较高，与 HIV- 退伍军人相比，患有心力衰竭的 HIV+ 退伍军人的住院和死亡风险更高，据报告，CD4 计数较低、病毒载量较高和射血分数较低的个体预后较差。
This study sought to investigate outcomes of heart failure (HF) in veterans living with human immunodeficiency virus (HIV). Data on outcomes of HF among people living with human immunodeficiency virus (PLHIV) are limited. We performed a retrospective cohort study of Veterans Health Affairs data to investigate outcomes of HF in PLHIV. We identified 5,747 HIV+ veterans with diagnosis of HF from 2000 to 2018 and 33,497 HIV− frequency-matched controls were included. Clinical outcomes included all-cause mortality, HF hospital admission, and all-cause hospital admission. Compared with HIV− veterans with HF, HIV+ veterans with HF were more likely to be black (56% vs. 14%), be smokers (52% vs. 29%), use alcohol (32% vs. 13%) or drugs (37% vs. 8%), and have a higher comorbidity burden (Elixhauser comorbidity index 5.1 vs. 2.6). The mean ejection fraction (EF) (45 ± 16%) was comparable between HIV+ and HIV− veterans. HIV+ veterans with HF had a higher age-, sex-, and race-adjusted 1-year all-cause mortality (30.7% vs. 20.3%), HF hospital admission (21.2% vs. 18.0%), and all-cause admission (50.2% vs. 38.5%) rates. Among veterans with HIV and HF, those with low CD4 count (<200 cells/ml) and high HIV viral load (>75 copies/μl) had worse outcomes. The associations remained statistically significant after adjusting for extensive list of covariates. The incidence of all-cause mortality and HF admissions was higher among HIV+ veterans with ejection fraction <45% HIV+ veterans with HF had higher risk of hospitalization and mortality compared with their HIV− counterparts, with worse outcomes reported for individuals with lower CD4 count, higher viral load, and lower ejection fraction.
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影响因子：
24
作者：
Alvi, Raza M.;Neilan, Anne M.;Neilan, Tomas G.
通讯作者：
Neilan, Tomas G.
影响因子：
39
作者：
Freiberg MS;Chang CC;Kuller LH;Skanderson M;Lowy E;Kraemer KL;Butt AA;Bidwell Goetz M;Leaf D;Oursler KA;Rimland D;Rodriguez Barradas M;Brown S;Gibert C;McGinnis K;Crothers K;Sico J;Crane H;Warner A;Gottlieb S;Gottdiener J;Tracy RP;Budoff M;Watson C;Armah KA;Doebler D;Bryant K;Justice AC
通讯作者：
Justice AC
影响因子：
13
作者：
Alvi, Raza M.;Neilan, Anne M.;Neilan, Tomas G.
通讯作者：
Neilan, Tomas G.
影响因子：
2.8
作者：
LEVY, WS;SIMON, GL;ROSS, AM
通讯作者：
ROSS, AM
影响因子：
5.4
作者：
Alvi RM;Neilan AM;Tariq N;Awadalla M;Rokicki A;Hassan M;Afshar M;Mulligan CP;Triant VA;Zanni MV;Neilan TG
通讯作者：
Neilan TG