Clinical characteristics of HIV-infected patients with adjudicated heart failure.
Clinical characteristics of HIV-infected patients with adjudicated heart failure.
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DOI：
10.1177/2047487317732432
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发表时间：
2017-11
影响因子：
8.3
通讯作者：
Feinstein MJ
中科院分区：
文献类型：
--
作者：
Steverson AB;Pawlowski AE;Schneider D;Nannapaneni P;Sanders JM;Achenbach CJ;Shah SJ;Lloyd-Jones DM;Feinstein MJ
HIV 感染者患心力衰竭的风险可能较高，但在现代 HIV 治疗时代，与心力衰竭相关的因素尚不清楚。尽管医生判定的心力衰竭和心力衰竭诊断代码之间存在很大分歧，但很少有针对 HIV 队列的研究评估判定的心力衰竭。我们评估了 HIV 病毒血症、免疫抑制和心血管危险因素与医生判定的心力衰竭的关联。我们分析了2000年至2016年间在城市医院系统接受护理的5041名HIV感染者的队列中与心力衰竭相关的临床特征。我们还评估了心力衰竭筛查阴性、可能心力衰竭筛查呈阳性但判定后没有心力衰竭以及判定心力衰竭的HIV感染者的特征。与没有心力衰竭的 HIV 感染者相比，患有心力衰竭的 HIV 感染者 (N = 216) 年龄更大，并且更有可能是黑人、高血压和糖尿病；射血分数降低的心力衰竭比射血分数保留的心力衰竭更常见。在我们的主要分析中，仅限于心力衰竭诊断未先于 HIV 诊断的 HIV 感染者 (N = 149)，HIV 病毒载量峰值≥100,000 拷贝/mL（比值比 (OR) 2.12, 1.28–3.52）和最低 CD4 T 细胞计数 <200 个细胞/mm3（OR 2.35, 1.04–5.31）与显着升高的比值相关。心力衰竭。总体而言，具有任何心力衰竭诊断代码的患者中有 30.6% 被判定患有心力衰竭。 HIV 病毒血症峰值较高和 CD4 细胞最低值较低与 HIV 感染者心力衰竭的几率显着升高相关。医生对心力衰竭的判断可能对艾滋病毒队列有帮助。
HIV-infected persons may have elevated risks for heart failure, but factors associated with heart failure in the modern era of HIV therapy are insufficiently understood. Despite substantial disagreement between physician-adjudicated heart failure and heart failure diagnosis codes, few studies of HIV cohorts have evaluated adjudicated heart failure. We evaluated associations of HIV viremia, immunosuppression, and cardiovascular risk factors with physician-adjudicated heart failure. We analyzed clinical characteristics associated with heart failure in a cohort of 5041 HIV-infected patients receiving care at an urban hospital system between 2000 and 2016. We also evaluated characteristics of HIV-infected patients who screened negative for heart failure, screened positive for possible heart failure but did not have heart failure after adjudication, and had adjudicated heart failure. HIV-infected patients with heart failure (N = 216) were older and more likely to be black, hypertensive, and have diabetes than HIV-infected patients without heart failure; heart failure with reduced ejection fraction was more common than heart failure with preserved ejection fraction. In our primary analyses restricted to HIV-infected patients whose heart failure diagnoses did not precede their HIV diagnoses (N = 149), peak HIV viral load ≥100,000 copies/mL (odds ratio (OR) 2.12, 1.28–3.52) and nadir CD4 T-cell count <200 cells/mm3 (OR 2.35, 1.04–5.31) were associated with significantly elevated odds of heart failure. Overall, 30.6% of patients with any diagnosis code of heart failure had adjudicated heart failure. Higher peak HIV viremia and lower CD4 cell nadir are associated with significantly elevated odds of heart failure for HIV-infected persons. Physician adjudication of heart failure may be helpful in HIV cohorts.
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影响因子：
5.7
作者：
Barnett, Christopher F.;Hsue, Priscilla Y.
通讯作者：
Hsue, Priscilla Y.
影响因子：
158.5
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Bozzette, SA;Ake, CF;Louis, TA
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Shlipak, Michael G.
DOI：
10.1080/09540121.2014.911813
发表时间：
2014-01-01
影响因子：
1.7
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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