Atrial Fibrillation and Atrial Flutter in Human Immunodeficiency Virus-Infected Persons Incidence, Risk Factors, and Association With Markers of HIV Disease Severity
Atrial Fibrillation and Atrial Flutter in Human Immunodeficiency Virus-Infected Persons Incidence, Risk Factors, and Association With Markers of HIV Disease Severity
复制标题
DOI：
10.1016/j.jacc.2013.03.022
复制
发表时间：
2013-06-04
影响因子：
24
通讯作者：
Shlipak, Michael G.
中科院分区：
文献类型：
--
作者：
Hsu, Jonathan C.;Li, Yongmei;Shlipak, Michael G.
目的本研究旨在探讨人类免疫缺陷病毒(HIV)疾病严重程度的传统危险因素和纵向指标与当代HIV感染者发生房颤(AF)风险的关系。背景心血管疾病在HIV感染者中很常见，但最常见的心律失常AF在该人群中尚未得到充分研究。方法我们研究了1996年至2011年在退伍军人事务部HIV临床病例登记中跟踪调查的30533名HIV感染退伍军人。我们使用多变量比例风险回归分析来检验人口学特征、及时更新的合并症以及包括CD4(+)细胞计数和病毒载量在内的及时更新的临床测量与房颤发生结果的独立关联。在对传统危险因素进行多变量调整后，较低的CD4(+)细胞计数(350cell/mm(3)；危险比[HR]：1.4；95%可信区间[CI]：1.1至1.8；p=0.018)和较高的病毒载量(与
Objectives The purpose of this study was to investigate the associations of traditional risk factors and longitudinal measures of human immunodeficiency virus (HIV) disease severity with risk of incident atrial fibrillation (AF) in a contemporary cohort of HIV-infected individuals.Background Cardiovascular disease is common in HIV-infected persons; however, the most common cardiac arrhythmia, AF, has not been adequately studied in this population.Methods We studied a national sample of 30,533 HIV-infected veterans followed in the Veterans Affairs HIV Clinical Case Registry from 1996 to 2011. We examined the independent associations of demographic characteristics, time-updated comorbidities, and time-updated clinical measurements including CD4(+) cell count and viral load with the outcome of incident AF using proportional hazards regression for multivariable analysis.Results Over a median follow-up of 6.8 years, 780 (2.6%) patients developed AF. After multivariable adjustment for traditional risk factors, a lower CD4(+) cell count (350 cells/mm(3); hazard ratio [HR]: 1.4; 95% confidence interval [CI]: 1.1 to 1.8; p = 0.018) and higher viral load (>100,000 compared with