Observed versus predicted cardiovascular events and all-cause death in HIV infection: a longitudinal cohort study

BMC Infectious Diseases

Research Article

Giuseppe Schillaci¹  Giacomo Pucci¹  Giuseppe Vittorio De Socio²  Franco Baldelli² 

[1] Department of Medicine, University of Perugia and Unit of Internal Medicine, “Santa Maria” Hospital, Terni, Italy;From the Department of Medicine, Unit of Infectious Diseases Azienda Ospedaliera of Perugia and University of Perugia, Santa Maria Hospital, Perugia, Italy;

关键词: HIV;    Atherosclerosis;    Framingham risk;    Cardiovascular diseases;    Mortality;   

DOI  :  10.1186/s12879-017-2510-x

 received in 2017-04-06, accepted in 2017-05-31,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe aim of the study was to assess the applicability of an algorithm predicting 10-year cardiovascular disease (CVD) generated in the setting of the Framingham Heart Study to a real-life, contemporary Italian cohort of HIV-positive subjects.MethodsThe study was an observational longitudinal cohort study. The probability for 10-year CVD events according to the Framingham algorithm was assessed in 369 consecutive HIV-positive participants free from overt CVD enrolled in 2004, who were followed for a median of 10.0 years (interquartile range, 9.1-10.1). Cardiovascular events included myocardial infarction, hospitalized heart failure, revascularized angina, sudden cardiac death, stroke, peripheral arterial disease.ResultsOver 3097 person-years of observation, we observed a total of 34 CVD events, whereas Framingham algorithm predicted the occurrence of 34.3 CVD events. CVD event rate was 11.0/1000 person-years of follow-up. In a receiver operating characteristics curve analysis, Framingham risk equation showed an excellent predictive value for incident CVD events (c-statistics, 0.83; 95% confidence interval, 0.76-0.90). In a multivariable Cox analysis, age, smoking and diabetes were independent predictors of CVD events. All-cause death rate was 20.0/1000 person-years of follow-up (n = 62 deaths). Causes of death included liver diseases (18), malignancies (14), AIDS-related (11); cardiovascular (9) and others (10). In a Cox analysis, age, AIDS diagnosis and chronic hepatitis were independent predictors of death.ConclusionsObserved CVD events in HIV-infected patients were well predicted by Framingham algorithm. Established major CVD risk factors are the strongest determinants of CVD morbidity in an Italian contemporary cohort of HIV-positive subjects. Interventions to modify traditional risk factors are urgently needed in HIV people.

【 授权许可】

CC BY   
© The Author(s). 2017