Comparison of ischemic stroke incidence in HIV-infected and non-HIV-infected patients in a US health care system.
Comparison of ischemic stroke incidence in HIV-infected and non-HIV-infected patients in a US health care system.
复制标题
DOI：
10.1097/qai.0b013e31825c7f24
复制
发表时间：
2012-08-01
期刊：
影响因子：
--
通讯作者：
Triant VA
中科院分区：
文献类型：
--
作者：
Chow FC;Regan S;Feske S;Meigs JB;Grinspoon SK;Triant VA
Cardiovascular disease is increased among HIV-infected patients, but little is known regarding ischemic stroke rates. We sought to compare stroke rates and determine stroke risk factors in HIV versus non-HIV patients. An HIV cohort and matched non-HIV comparator cohort seen between 1996 and 2009 were identified from a Boston health care system. The primary endpoint was ischemic stroke, defined using International Classification of Diseases (ICD) codes. Unadjusted stroke incidence rates were calculated. Cox proportional hazards modeling was used to determine adjusted hazard ratios (HR). The incidence rate of ischemic stroke was 5.27 per 1000 person years (PY) in HIV compared with 3.75 in non-HIV patients, with an unadjusted HR of 1.40 (95% confidence interval [CI] 1.17-1.69, P<0.001). HIV remained an independent predictor of stroke after controlling for demographics and stroke risk factors (1.21, 1.01-1.46, P=0.043). The relative increase in stroke rates (HIV vs. non-HIV) was significantly higher in younger HIV patients (incidence rate ratio 4.42, 95% CI 1.56-11.09 age 18-29; 2.96, 1.69-4.96 age 30-39; 1.53, 1.06-2.17 age 40-49), and in women (HR 2.16 [1.53-3.04] for women vs. 1.18 [0.95-1.47] for men). Among HIV patients, increased HIV RNA (HR 1.10, 95% CI 1.04-1.17, P=0.001) was associated with an increased risk of stroke. Stroke rates were increased among HIV-infected patients, independent of common stroke risk factors, particularly among young patients and women.
