Incidence and Predictors of Myocardial Infarction Among HIV-Infected Patients

描述（由候选人提供）：在一个时代，当艾滋病毒感染的患者在抗逆转录病毒治疗的寿命更长，了解长期艾滋病毒感染的并发症及其治疗是至关重要的照顾这个群体。最近的研究表明，艾滋病毒患者的心血管风险因素增加，一些研究评估了艾滋病毒患者的冠心病发病率。然而，迄今为止还没有研究对艾滋病毒感染者与人口统计学匹配的非艾滋病毒对照者进行前瞻性比较。本研究的主要目的是采用前瞻性观察性研究设计，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：研究来自大型医疗保健系统数据登记处的HIV和非HIV队列的基线特征和心血管风险特征。 目标二：在一项前瞻性病例队列研究中，从基于大型医疗保健系统的数据登记中确定HIV和非HIV队列4年内急性心肌梗死的发病率。 目标3：在多变量回归模型中分析急性心肌梗死的预测因素，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，使研究者能够生成队列并跟踪大量患者的结局，这些患者的全面人口统计学和临床数据都是可靠的。这项研究的结果将对HIV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艾滋病毒感染的情况下心脏病风险被认为很低的群体（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、风险调整和针对艾滋病患者的治疗策略。随着抗逆转录病毒疗法的普及，这种战略在资源有限的环境中可能会越来越重要。艾滋病毒和心血管疾病的交叉是一个新兴的重要领域。候选人的承诺和背景，具有广泛专业知识的导师团队以及广泛的机构资源的力量将提供一个独特的适合的环境，以促进临床研究的职业发展和改善艾滋病毒患者的福祉。

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.