Incidence and Predictors of Myocardial Infarction Among HIV-Infected Patients

HIV 感染者心肌梗塞的发病率和预测因素

• 批准号: 7494847
• 负责人: Virginia Athena Triant
• 金额: $ 13.63万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7494847
• 关键词: Acute myocardial infarction; Age; Cardiac; Cardiovascular Diseases; Caring; Characteristics; Clinical; Clinical Data; Clinical Trials; Cohort Studies; Coronary heart disease; Cross-Sectional Studies; Data; Data Sources; Databases; Development; Diabetes Mellitus; Disease regression; Dyslipidemias; Environment; Gender; Goals; HIV; HIV Infections; Healthcare Systems; Hypertension; Incidence; Life; Mentors; Modeling; Modification; Myocardial Infarction; Numbers; Observational Study; Outcome; Patients; Personal Satisfaction; Public Health Applications Research; Race; Range; Rate; Registries; Research Design; Research Personnel; Resources; Risk; Risk Factors; Smoking; Thinking; Validation; Woman; antiretroviral therapy; cardiovascular risk factor; career; cohort; improved; insight; novel; prospective; tool

DESCRIPTION (provided by candidate): In an era when HIV-infected patients are living longer on antiretroviral therapy, understanding the complications of long-standing HIV infection and its treatment is critical to the care of this group. Recent studies indicate increased rates of cardiovascular risk factors among HIV patients, and several studies have evaluated coronary heart disease rates among HIV patients. No study to date, however, has examined the issue prospectively comparing HIV patients to demographically matched non-HIV controls. The primary aim of the proposed study is to examine the incidence and predictors of myocardial infarction among an HIV cohort compared to a non-HIV cohort using a prospective observational study design. Specific aims include: Aim 1: To investigate the baseline characteristics and cardiovascular risk profile of HIV and non-HIV cohorts derived from a large health care system-based data registry. Aim 2: To determine the incidence of acute myocardial infarction over a four-year period in HIV and non-HIV cohorts derived from a large health care system-based data registry in a prospective case cohort study. Aim 3: To analyze the predictors of acute myocardial infarction in a multivariate regression model and to validate a risk prediction tool in HIV and non-HIV cohorts. To achieve these goals, a unique data source will be employed that allows investigators to generate cohorts and track outcomes for large numbers of patients for whom comprehensive demographic and clinical data are reliably captured. The results of this study will have implications for the optimal management of HIV patients with respect to cardiovascular disease. These insights will be especially important for groups in whom cardiac risk is thought to be low in the absence of HIV infection, such as young women. The public health applications of this research will include the development of cardiovascular risk prediction, risk modification, and treatment strategies tailored to HIV patients. Such strategies will likely take on increasing importance in resource-limited settings as antiretroviral therapy becomes more widely available. The intersection of HIV and cardiovascular disease is an emerging and significant field. The strength of the candidate's commitment and background, a team of mentors with a wide range of expertise, and extensive institutional resources will provide a uniquely well-suited environment to promote career development in clinical investigation and improve the well being of HIV patients.

描述（由候选人提供）：在 HIV 感染者接受抗逆转录病毒治疗后寿命更长的时代，了解长期 HIV 感染的并发症及其治疗对于该群体的护理至关重要。最近的研究表明，艾滋病毒患者中心血管危险因素的发生率有所增加，并且有几项研究评估了艾滋病毒患者中冠心病的发生率。然而，迄今为止还没有研究前瞻性地将艾滋病毒患者与人口统计学匹配的非艾滋病毒对照进行比较。拟议研究的主要目的是使用前瞻性观察研究设计，与非 HIV 队列相比，检查 HIV 队列中心肌梗死的发病率和预测因素。具体目标包括： 目标 1：调查基于大型医疗保健系统数据登记的 HIV 和非 HIV 队列的基线特征和心血管风险状况。 目标 2：通过一项前瞻性病例队列研究，通过基于大型医疗保健系统的数据登记，确定四年期间 HIV 和非 HIV 队列中急性心肌梗死的发病率。 目标 3：在多元回归模型中分析急性心肌梗死的预测因子，并在 HIV 和非 HIV 队列中验证风险预测工具。 为了实现这些目标，将采用独特的数据源，使研究人员能够生成队列并跟踪大量患者的结果，并可靠地捕获全面的人口统计和临床数据。这项研究的结果将对艾滋病毒患者心血管疾病的最佳管理产生影响。这些见解对于那些在没有感染艾滋病毒的情况下心脏病风险较低的群体（例如年轻女性）尤其重要。这项研究的公共卫生应用将包括开发心血管风险预测、风险修正以及针对艾滋病毒患者的治疗策略。随着抗逆转录病毒疗法的普及，此类策略在资源有限的环境中可能会变得越来越重要。艾滋病毒与心血管疾病的交叉是一个新兴且重要的领域。候选人的奉献精神和背景、拥有广泛专业知识的导师团队以及广泛的机构资源将为促进临床研究职业发展和改善艾滋病毒患者的福祉提供独特的合适环境。