Disparities in the Quality of Cardiovascular Care Between HIV-Infected Versus HIV-Uninfected Adults in the United States: A Cross-Sectional Study
Disparities in the Quality of Cardiovascular Care Between HIV-Infected Versus HIV-Uninfected Adults in the United States: A Cross-Sectional Study
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DOI：
10.1161/jaha.117.007107
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发表时间：
2017-11-01
影响因子：
5.4
通讯作者：
Mafi, John N.
中科院分区：
文献类型：
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作者：
Ladapo, Joseph A.;Richards, Adam K.;Mafi, John N.
背景-心血管疾病正在成为HIV感染者发病和死亡的主要原因。我们比较了使用国家指南推荐的心血管护理在办公室访问中HIV感染者与HIV未感染adultes.Methods和Results-We的数据进行分析，从全国代表性样本的HIV感染者和HIV未感染的患者年龄在40至79岁的国家门诊医疗服务调查/全国医院门诊医疗服务调查，2006年至2013年。结果是提供指南推荐的心血管护理。根据临床和人口统计学因素调整倾向评分加权的逻辑回归。我们确定了1631例HIV感染患者和226862例有心血管危险因素的HIV未感染患者的就诊，分别代表美国每年约220万和6.02亿次就诊。当患者符合指南推荐的一级预防标准或患有心血管疾病时，HIV感染者与未感染HIV的成年人接受阿司匹林/抗血小板治疗的比例分别为5.1%与13.8%（P=0.03）;当患者患有糖尿病、心血管疾病或血脂异常时，接受他汀类药物治疗的比例分别为23.6%与35.8%（P=0.03）。
Background-Cardiovascular disease is emerging as a major cause of morbidity and mortality among patients with HIV. We compared use of national guideline-recommended cardiovascular care during office visits among HIV-infected versus HIV-uninfected adults.Methods and Results-We analyzed data from a nationally representative sample of HIV-infected and HIV-uninfected patients aged 40 to 79 years in the National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey, 2006 to 2013. The outcome was provision of guideline-recommended cardiovascular care. Logistic regressions with propensity score weighting adjusted for clinical and demographic factors. We identified 1631 visits by HIV-infected patients and 226 862 visits by HIV-uninfected patients with cardiovascular risk factors, representing approximate to 2.2 million and 602 million visits per year in the United States, respectively. The proportion of visits by HIV-infected versus HIV-uninfected adults with aspirin/antiplatelet therapy when patients met guideline-recommended criteria for primary prevention or had cardiovascular disease was 5.1% versus 13.8% (P=0.03); the proportion of visits with statin therapy when patients had diabetes mellitus, cardiovascular disease, or dyslipidemia was 23.6% versus 35.8% (P