Increased risk of myocardial infarction with duration of protease inhibitor therapy in HIV-infected men
Increased risk of myocardial infarction with duration of protease inhibitor therapy in HIV-infected men
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DOI：
10.1097/00002030-200311210-00010
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发表时间：
2003-11-21
期刊：
影响因子：
3.8
通讯作者：
Costagliola, D
中科院分区：
文献类型：
--
作者：
Mary-Krause, M;Cotteb, L;Costagliola, D
背景：在当前 HIV 血清阳性受试者中观察到的血脂异常、高血糖和脂肪营养不良的背景下，研究该人群发生心肌梗死 (MI) 的风险非常重要。法国医院 HIV 数据库包含大量长期随访的血清阳性受试者，为分析蛋白酶抑制剂 (PI) 对男性 MI 风险的影响提供了机会。 方法：使用 Cox 模型研究 MI 发生的危险因素。以同龄法国一般男性人群(FGMP)的数据为参考，计算PI暴露男性的标准化发病率(SMR)。结果：1996年至1999年间，88 029人年(PY)中，有60名男性被诊断为MI，其中PI暴露男性中有49例。在 Cox 模型中，暴露于 PI 与较高的 MI 风险相关[相对危险 (RH)，2.56； 95% 置信区间 (CI)，1.03-6.34]。 FGMP 中的预期发病率为 10.8/10000 PY。对于暴露于 PI < 18 个月 (G1) 的男性，相对于 FGMP 的 SMR 为 0.8 (95% CI, 0.5-1.3)；对于暴露 18-29 个月 (G2) 的男性，相对于 FGMP 的 SMR 为 1.5 (95% CI, 0.8-2.5)；对于暴露超过或等于 30 个月的男性 (G3)，相对于 FGMP 的 SMR 为 2.9 (95% CI, 1.5-5.0)。以 G1 为参考，G2 的 SMR 为 1.9（95% CI，1.0-3.1），G3 为 3.6（95% CI，1.8-6.2）。 结论：我们的结果表明 PI 和 MI 之间存在持续时间相关的效应关系，接触 Pi 18 个月或更长时间的男性 MI 发生率较高。 (C) 2003 年利平科特·威廉姆斯·威尔金斯。
Background: In the current context of dyslipidaema, hyperglycaema and lipodystrophia observed among HIV-seropositive subjects, it is important to study the risk of myocardial infarction (MI) in this population. The French Hospital Database on HIV, which includes a large number of seropositive subjects followed for substantial periods, offers the opportunity to analyse the impact of protease inhibitors (PI) on the risk of MI among men.Methods: Cox model was used to study the risk factors of MI occurrence. Standardized morbidity ratios (SMR) in men exposed to PI were calculated with data from the French general male population (FGMP) of the same age as reference.Results: Between 1996 and 1999, MI was diagnosed in 60 men among 88 029 person-years (PY), including 49 cases among men exposed to PI. In the Cox model, exposure to PI was associated with a higher risk of MI [relative hazard (RH), 2.56; 95% confidence interval (CI), 1.03-6.34]. The expected incidence in the FGMP was 10.8/10000 PY. The SMR relative to the FGMP was 0.8 (95% CI, 0.5-1.3) for men exposed to PI for < 18 months (G1), 1.5 (95% CI, 0.8-2.5) for men exposed for 18-29 months (G2) and 2.9 (95% CI, 1.5-5.0) for men exposed for greater than or equal to 30 months (G3). With G1 as reference, the SMR was 1.9 (95% CI, 1.0-3.1) for G2 and 3.6 (95% CI, 1.8-6.2) for G3.Conclusion: Our results point to a duration-related effect relationship between PI and MI, with a higher MI incidence rate among men exposed to Pi for 18 months or more. (C) 2003 Lippincott Williams Wilkins.