The concomitant use of second-generation antipsychotics and long-term antiretroviral therapy may be associated with increased cardiovascular risk

PSYCHIATRY RESEARCH

卷:218

Article

Ferrara, Maria^1,2  Umlauf, Anya²  Sanders, Chelsea²  Meyer, Jonathan M.^3,4  McCutchan, John Allen²  Duarte, Nichole²  Atkinson, Joseph Hampton^2,4  Grant, Igor²  Ellis, Ronald J.² 

[1] AUSL Modena, Dept Mental Hlth, I-41121 Modena, Italy

[2] Univ Calif San Diego, HIV Neurobehav Res Program HNRP, San Diego, CA 92103 USA

[3] Univ Calif San Diego, Dept Psychiat, La Jolla, CA 92093 USA

[4] VA San Diego Healthcare Syst, Psychiat Serv, La Jolla, CA 92161 USA

关键词: HIV;    Cardiovascular risk;    Serious mental illness;    Diabetes mellitus;    Obesity;    Hypertriglyceridemia;    Hypertension;   

DOI  :  10.1016/j.psychres.2014.04.015

来源: Elsevier

【 摘 要 】

To study the effect of concurrent use of second-generation antipsychotics (SGAs) on metabolic syndrome (MetS) components conferring increased cardiovascular risk in a sample of human immunodeficiency virus (HIV)-infected adults taking antiretroviral therapy (ART). A retrospective study of participants consecutively recruited at the UCSD HIV Neurobehavioral Research Program examined effects of combined ART and SGAs on body mass index (BMI), nonfasting serum lipids, diabetes mellitus (DM) incidence, and mean arterial pressure (MAP). Metabolic outcome variables and covariates were compared using t-tests, Chi-squared or Fisher's exact tests. Linear and logistic multivariable models explored metabolic outcomes for participants taking (SGA+) or not taking (SGA-) concomitant SGAs, after controlling for demographic and HIV disease- and ART-related covariates. Of 2229 HIV-infected participants, 12% (N=258) were treated with SGAs. In multivariable models adjusted for relevant covariates, the SGA+ group had significantly higher mean triglycerides, significantly higher odds of DM, significantly higher MAPs and marginally higher BMI. The use of SGAs in HIV-infected adults taking ART was independently associated with worse indicators of MetS and cardiovascular risk. Aggressive monitoring for the metabolic complications from concurrent SGA and ART is indicated in all patients receiving these medication combinations. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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