Carotid atherosclerosis in virologically suppressed HIV patients: comparison with a healthy sample and prediction by cardiovascular risk equations
Por:
Saumoy, M, Di Yacovo, S, Perez, S, Sanchez-Quesada, JL, Valdivielso, JM, Subirana, I, Imaz, A, Tiraboschi, JM, Garcia, B, Ordonez-Llanos, J, Benitez, S, Podzamczer, D, Grau, M
Publicada:
1 ago 2021
Ahead of Print:
1 abr 2021
Resumen:
Objectives To compare the prevalence of carotid atherosclerosis in virologically suppressed HIV patients with that of a community sample, and to evaluate the capacity of various cardiovascular risk (CVR) equations for predicting carotid atherosclerosis.
Methods This was a cross-sectional study with two randomly selected groups: HIV patients from an HIV unit and a control group drawn from the community. Participants were matched by age (30-80 years) and sex without history of cardiovascular disease. Carotid plaque, common carotid intima-media thickness (cc-IMT) and subclinical atherosclerosis (carotid plaque and/or cc-IMT > 75(th) percentile) were assessed by carotid ultrasound. The Systematic Coronary Risk Evaluation (SCORE), Framingham, REGICOR, reduced Data Collection on Adverse Effects of Anti-HIV Drugs (D:A:D), and COMVIH equations were applied, and their abilities to predict carotid plaque were compared using the area under the curve (AUC).
Results Each group included 379 subjects (77.8% men, age 49.7 years). Duration of antiretroviral therapy was 15.5 years. There were no differences between the groups for carotid plaque (HIV, 33.2%; control, 31.3%), mean cc-IMT (HIV, 0.63 mm; control, 0.61 mm) or subclinical atherosclerosis (HIV, 42.9%; control, 47.9%). Thymidine analogues were independently associated with subclinical atherosclerosis in HIV-infected patients. CVR equations revealed AUCs between 0.715 and 0.807 for prediction of carotid plaque; prediction was better in the control group and did not improve when HIV-adapted scales were used.
Conclusions The features of carotid atherosclerosis did not differ between the HIV-infected and the control group, although CVR equations were more predictive for carotid plaque in controls than in HIV-infected patients. HIV-specific equations did not improve prediction.
Filiaciones:
Saumoy, M:
Bellvitge Univ Hosp, HIV & STD Unit, Infect Dis Dept, Lhospitalet De Llobregat, Spain
Bellvitge Inst Biomed Res, Lhospitalet De Llobregat, Spain
Di Yacovo, S:
Bellvitge Univ Hosp, HIV & STD Unit, Infect Dis Dept, Lhospitalet De Llobregat, Spain
Bellvitge Inst Biomed Res, Lhospitalet De Llobregat, Spain
Perez, S:
Hosp del Mar, Inst Med Res IMIM, Barcelona, Spain
Consortium Biomed Res Cardiovasc Dis CIBERCV, Barcelona, Spain
Sanchez-Quesada, JL:
Biomed Res Inst IIB St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Biochem & Mol Biol Dept, Barcelona, Spain
Valdivielso, JM:
UDETMA, Vasc & Renal Translat Res Grp, IRB, Biomed Res Inst Lleida, Lleida, Spain
Subirana, I:
Hosp del Mar, Inst Med Res IMIM, Barcelona, Spain
Consortium Biomed Res Epidemiol & Publ Hlth CIBER, Barcelona, Spain
Imaz, A:
Bellvitge Univ Hosp, HIV & STD Unit, Infect Dis Dept, Lhospitalet De Llobregat, Spain
Bellvitge Inst Biomed Res, Lhospitalet De Llobregat, Spain
Tiraboschi, JM:
Bellvitge Univ Hosp, HIV & STD Unit, Infect Dis Dept, Lhospitalet De Llobregat, Spain
Bellvitge Inst Biomed Res, Lhospitalet De Llobregat, Spain
Garcia, B:
Bellvitge Univ Hosp, HIV & STD Unit, Infect Dis Dept, Lhospitalet De Llobregat, Spain
Ordonez-Llanos, J:
Biomed Res Inst IIB St Pau, Barcelona, Spain
Univ Autonoma Barcelona, Biochem & Mol Biol Dept, Barcelona, Spain
Benitez, S:
Univ Autonoma Barcelona, Biochem & Mol Biol Dept, Barcelona, Spain
Podzamczer, D:
Bellvitge Univ Hosp, HIV & STD Unit, Infect Dis Dept, Lhospitalet De Llobregat, Spain
Bellvitge Inst Biomed Res, Lhospitalet De Llobregat, Spain
Grau, M:
Consortium Biomed Res Epidemiol & Publ Hlth CIBER, Barcelona, Spain
Univ Barcelona, Dept Med, Barcelona, Spain
Hosp del Mar, Inst Med Res IMIM, Barcelona, Spain
Green Accepted
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