Predicting the risk of cardiovascular disease in HIV-infected patients: the Data collection on Adverse Effects of Anti-HIV Drugs Study
Predicting the risk of cardiovascular disease in HIV-infected patients: the Data collection on Adverse Effects of Anti-HIV Drugs Study
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DOI：
10.1097/hjr.0b013e328336a150
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发表时间：
2010-10-01
影响因子：
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通讯作者：
Law, Matthew G.
中科院分区：
文献类型：
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作者：
Friis-Moller, Nina;Thiebaut, Rodolphe;Law, Matthew G.
目的接受抗逆转录病毒联合治疗的艾滋病毒感染者可能会出现代谢并发症，潜在地增加他们患心血管疾病（cvd）的风险。此外，暴露于某些抗逆转录病毒药物似乎与心血管疾病风险增加独立相关。我们的目标是开发适合艾滋病毒感染患者的心血管风险评估模型。方法和结果前瞻性多国队列研究。数据集包括来自欧洲和澳大利亚20个国家的22 625名hiv感染者，他们在抗hiv药物不良反应研究数据收集时没有心血管疾病。使用交叉验证方法，开发了单独的模型来预测心肌梗死、冠心病和复合心血管疾病终点的风险。将模型性能与Framingham评分进行比较。这些模型包括年龄、性别、收缩压、吸烟状况、心血管疾病家族史、糖尿病、总胆固醇、高密度脂蛋白胆固醇和因地那韦、洛匹那韦/r和阿巴卡韦暴露。模型表现良好，心肌梗死、冠心病和心血管疾病的接收算子曲线下面积分别为0.783（0.642 ~ 0.820）、0.776（0.670 ~ 0.818）和0.769（0.695 ~ 0.824）。与Framingham评分相比，该模型对亚组结果的估计更为准确。结论：从艾滋病毒感染者群体中建立的风险方程，结合常规收集的心血管风险参数和个体抗逆转录病毒治疗药物的暴露，可能比传统的风险预测模型更有助于估计艾滋病毒感染者的心血管疾病风险。中华心血管病杂志，17 (5):391 - 391 (C) 2010
Aims HIV-infected patients receiving combination antiretroviral therapy may experience metabolic complications, potentially increasing their risk of cardiovascular diseases (CVDs). Furthermore, exposures to some antiretroviral drugs seem to be independently associated with increased CVD risk. We aimed to develop cardiovascular risk-assessment models tailored to HIV-infected patients.Methods and results Prospective multinational cohort study. The data set included 22 625 HIV-infected patients from 20 countries in Europe and Australia who were free of CVD at entry into the Data collection on Adverse Effects of Anti-HIV Drugs Study. Using cross-validation methods, separate models were developed to predict the risk of myocardial infarction, coronary heart disease, and a composite CVD endpoint. Model performance was compared with the Framingham score. The models included age, sex, systolic blood pressure, smoking status, family history of CVD, diabetes, total cholesterol, HDL cholesterol and indinavir, lopinavir/r and abacavir exposure. The models performed well with area under the receiver operator curve statistics of 0.783 (range 0.642-0.820) for myocardial infarction, 0.776 (0.670-0.818) for coronary heart disease and 0.769 (0.695-0.824) for CVD. The models estimated more accurately the outcomes in the subgroups than the Framingham score.Conclusion Risk equations developed from a population of HIV-infected patients, incorporating routinely collected cardiovascular risk parameters and exposure to individual antiretroviral therapy drugs, might be more useful in estimating CVD risks in HIV-infected persons than conventional risk prediction models. Eur J Cardiovasc Prev Rehabil 17:491-501 (C) 2010 The European Society of Cardiology