Incidence and Predictors of Myocardial Infarction Among HIV-Infected Patients

描述(由Candiate提供)：在艾滋病毒感染患者接受抗逆转录病毒治疗的寿命更长的时代，了解长期感染艾滋病毒的并发症及其治疗对这一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增加，几项研究评估了艾滋病毒患者中冠心病的发生率。然而，到目前为止，还没有研究对这一问题进行前瞻性比较，将艾滋病毒患者与人口统计学上匹配的非艾滋病毒对照进行比较。这项拟议研究的主要目的是使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生率和预测因素。具体目标包括： 目的1：调查来自大型卫生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概况。 目的2：在一项前瞻性病例队列研究中，从基于大型卫生保健系统的数据登记中确定四年期间HIV和非HIV队列中急性心肌梗死的发生率。 目的：在多因素回归模型中分析急性心肌梗死的预测因素，并验证在HIV和非HIV队列中的风险预测工具。 为了实现这些目标，将使用一个独特的数据源，使调查人员能够生成队列并跟踪大量患者的结果，这些患者的全面人口统计和临床数据得到了可靠的捕获。这项研究的结果将对艾滋病患者在心血管疾病方面的最佳管理产生影响。这些见解对于那些被认为在没有艾滋病毒感染的情况下心脏风险较低的群体，如年轻女性，将特别重要。这项研究的公共卫生应用将包括为HIV患者量身定做的心血管风险预测、风险修正和治疗策略的开发。随着抗逆转录病毒疗法变得越来越广泛，这种战略在资源有限的情况下可能会变得越来越重要。艾滋病毒和心血管疾病的交叉是一个新兴和重要的领域。候选人的承诺和背景、具有广泛专业知识的导师团队和广泛的机构资源将提供一个独特的非常适合的环境，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.