Protease inhibitors and cardiovascular outcomes in patients with HIV-1

Protease inhibitors and cardiovascular outcomes in patients with HIV-1
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DOI:
10.1016/s0140-6736(02)11672-2
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发表时间:
2002-11-30
期刊:
影响因子:
168.9
通讯作者:
Janssen, RS
Janssen, RS
中科院分区:
医学1区
文献类型:
--
作者:
Holmberg, SD;Moorman, AC;Janssen, RS

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用于治疗 HIV-1 的蛋白酶抑制剂与高脂血症和高血糖风险增加有关。 1993 年 1 月至 2002 年 1 月期间,在美国 9 个 HIV 诊所就诊的 5672 名 HIV-1 门诊患者的队列中,1996 年引入蛋白酶抑制剂后,心肌梗塞的发生率有所增加(趋势检验,p=0.0125)。我们注意到,服用蛋白酶抑制剂的 3247 名患者中,有 19 名患者患有心肌梗死,而 2425 名未服用蛋白酶抑制剂的患者中只有 2 名患者出现心肌梗死(比值比 7.1,95% CI 1.6-44.3;针对吸烟、性别、年龄、糖尿病、高脂血症和高血压风险比进行调整的 Cox 比例风险模型为 6.5、0.9-47.8)。我们的研究结果表明,虽然不常见,但蛋白酶抑制剂的使用与 HIV-1 患者心肌梗塞风险增加相关。
Protease inhibitors for treatment of HIV-1 have been linked with increased risk of hyperlipidaemia and hyperglycaemia. In a cohort of 5672 outpatients with HIV-1 seen at nine US HIV clinics between January, 1993, and January, 2002, the frequency of myocardial infarctions increased after the introduction of protease inhibitors in 1996 (test for trend, p=0.0125). We noted that 19 of 3247 patients taking, but only two of 2425 who did not take, protease inhibitors had a myocardial infarction (odds ratio 7.1, 95% CI 1.6-44.3; Cox proportional hazards model-adjusted for smoking, sex, age, diabetes, hyperlipidaemia, and hypertension-hazard ratio 6.5, 0.9-47.8). Our findings suggest that, although infrequent, use of protease inhibitors is associated with increased risk of myocardial infarction in patients with HIV-1.