HIV infection and cardiovascular disease in women.
HIV infection and cardiovascular disease in women.
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DOI：
10.1161/jaha.114.001035
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发表时间：
2014-10-16
影响因子：
5.4
通讯作者：
Freiberg MS
中科院分区：
文献类型：
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作者：
Womack JA;Chang CC;So-Armah KA;Alcorn C;Baker JV;Brown ST;Budoff M;Butt AA;Gibert C;Goetz MB;Gottdiener J;Gottlieb S;Justice AC;Leaf D;McGinnis K;Rimland D;Rodriguez-Barradas MC;Sico J;Skanderson M;Tindle H;Tracy RP;Warner A;Freiberg MS
HIV感染与男性心血管疾病（CVD）风险增加有关。艾滋病毒是否是女性心血管疾病的独立危险因素尚未确定。我们分析了来自退伍军人老龄化队列研究的2187名妇女（32%的HIV感染[HIV+]）的数据，这些妇女在基线时没有CVD。参与者从2003年4月1日或之后的首次临床就诊开始接受随访，直至发生CVD事件、死亡或末次随访日期（2009年12月31日）。主要结局为CVD（急性心肌梗死[AMI]、不稳定型心绞痛、缺血性卒中和心力衰竭）。使用临床数据、国际疾病分类第九版、临床修改代码和/或死亡证明数据定义CVD事件。我们使用考克斯比例风险模型来评估HIV和CVD事件之间的关联，调整了年龄、种族/民族、血脂、吸烟、血压、糖尿病、肾脏疾病、肥胖、丙型肝炎和物质使用/滥用。中位随访时间为6.0年。HIV阳性和未感染HIV（HIV-）妇女的基线平均年龄分别为44.0岁和43.2岁（P<0.05）。至发生CVD事件的中位时间分别为3.1年和3.7年（P=0.11）。共有86例CVD事件（53%，HIV+）：AMI，13%;不稳定型心绞痛，8%;缺血性卒中，22%;心力衰竭，57%。HIV阳性者的CVD发病率/1000人年（13.5; 95%置信区间[CI]=10.1，18.1）显著高于HIV阴性者（5.3; 95% CI=3.9，7.3; P<0.001）。与HIV阴性女性相比，HIV阳性女性CVD风险增加（风险比=2.8; 95% CI=1.7，4.6; P<0.001）。艾滋病毒与女性心血管疾病风险增加有关。
HIV infection is associated with increased risk of cardiovascular disease (CVD) in men. Whether HIV is an independent risk factor for CVD in women has not yet been established. We analyzed data from the Veterans Aging Cohort Study on 2187 women (32% HIV infected [HIV+]) who were free of CVD at baseline. Participants were followed from their first clinical encounter on or after April 01, 2003 until a CVD event, death, or the last follow‐up date (December 31, 2009). The primary outcome was CVD (acute myocardial infarction [AMI], unstable angina, ischemic stroke, and heart failure). CVD events were defined using clinical data, International Classification of Diseases, Ninth Revision, Clinical Modification codes, and/or death certificate data. We used Cox proportional hazards models to assess the association between HIV and incident CVD, adjusting for age, race/ethnicity, lipids, smoking, blood pressure, diabetes, renal disease, obesity, hepatitis C, and substance use/abuse. Median follow‐up time was 6.0 years. Mean age at baseline of HIV+ and HIV uninfected (HIV−) women was 44.0 versus 43.2 years (P<0.05). Median time to CVD event was 3.1 versus 3.7 years (P=0.11). There were 86 incident CVD events (53%, HIV+): AMI, 13%; unstable angina, 8%; ischemic stroke, 22%; and heart failure, 57%. Incident CVD/1000 person‐years was significantly higher among HIV+ (13.5; 95% confidence interval [CI]=10.1, 18.1) than HIV− women (5.3; 95% CI=3.9, 7.3; P<0.001). HIV+ women had an increased risk of CVD, compared to HIV− (hazard ratio=2.8; 95% CI=1.7, 4.6; P<0.001). HIV is associated with an increased risk of CVD in women.