Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected Patients

Detalhes bibliográficos
Autor(a) principal: Salmazo,Péricles Sidnei
Data de Publicação: 2018
Outros Autores: Bazan,Silméia Garcia Zanati, Shiraishi,Flávio Gobbis, Bazan,Rodrigo, Okoshi,Katashi, Hueb,João Carlos
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Arquivos Brasileiros de Cardiologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018000500402
Resumo: Abstract Background: AIDS as well as atherosclerosis are important public health problems. The longer survival among HIV-infected is associated with increased number of cardiovascular events in this population, and this association is not fully understood. Objectives: To identify the frequency of subclinical atherosclerosis in HIV-infected patients compared to control subjects; to analyze associations between atherosclerosis and clinical and laboratory variables, cardiovascular risk factors, and the Framingham coronary heart disease risk score (FCRS). Methods: Prospective cross-sectional case-control study assessing the presence of subclinical atherosclerosis in 264 HIV-infected patients and 279 controls. Clinical evaluation included ultrasound examination of the carotid arteries, arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx), laboratory analysis of peripheral blood, and cardiovascular risk according to FCRS criteria. The significance level adopted in the statistical analysis was p < 0.05. Results: Plaques were found in 37% of the HIV group and 4% of controls (p < 0.001). Furthermore, carotid intima-media thickness was higher in the HIV group than in controls (p < 0.001). Patients with carotid plaque had higher fasting glucose, total cholesterol, low-density lipoprotein cholesterol, and triglycerides than those without plaques. The presence of HIV, adjusted for age, overweight/obesity, and smoking increased by almost fivefold the risk of atherosclerotic carotid plaque (OR: 4.9; 95%CI: 2.5-9.9; p < 0.001). Exposure to protease inhibitors did not influence carotid intima-media thickness, was not associated with carotid plaque frequency, and did not alter the mechanical characteristics of the arterial system (PWV and AIx). Conclusions: HIV-infected patients are at increased risk of atherosclerosis in association with classical cardiovascular risk factors. Treatment with protease inhibitors does not promote functional changes in the arteries, and shows no association with increased frequency of atherosclerotic plaques in carotid arteries. The FCRS may be inappropriate for this population.
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spelling Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected PatientsAtherosclerosis / complicationsHIVCardiovascular Diseases / mortalityCarotid Intima Media CarotideoVascular StiffnessRisk FactorsAbstract Background: AIDS as well as atherosclerosis are important public health problems. The longer survival among HIV-infected is associated with increased number of cardiovascular events in this population, and this association is not fully understood. Objectives: To identify the frequency of subclinical atherosclerosis in HIV-infected patients compared to control subjects; to analyze associations between atherosclerosis and clinical and laboratory variables, cardiovascular risk factors, and the Framingham coronary heart disease risk score (FCRS). Methods: Prospective cross-sectional case-control study assessing the presence of subclinical atherosclerosis in 264 HIV-infected patients and 279 controls. Clinical evaluation included ultrasound examination of the carotid arteries, arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx), laboratory analysis of peripheral blood, and cardiovascular risk according to FCRS criteria. The significance level adopted in the statistical analysis was p < 0.05. Results: Plaques were found in 37% of the HIV group and 4% of controls (p < 0.001). Furthermore, carotid intima-media thickness was higher in the HIV group than in controls (p < 0.001). Patients with carotid plaque had higher fasting glucose, total cholesterol, low-density lipoprotein cholesterol, and triglycerides than those without plaques. The presence of HIV, adjusted for age, overweight/obesity, and smoking increased by almost fivefold the risk of atherosclerotic carotid plaque (OR: 4.9; 95%CI: 2.5-9.9; p < 0.001). Exposure to protease inhibitors did not influence carotid intima-media thickness, was not associated with carotid plaque frequency, and did not alter the mechanical characteristics of the arterial system (PWV and AIx). Conclusions: HIV-infected patients are at increased risk of atherosclerosis in association with classical cardiovascular risk factors. Treatment with protease inhibitors does not promote functional changes in the arteries, and shows no association with increased frequency of atherosclerotic plaques in carotid arteries. The FCRS may be inappropriate for this population.Sociedade Brasileira de Cardiologia - SBC2018-05-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018000500402Arquivos Brasileiros de Cardiologia v.110 n.5 2018reponame:Arquivos Brasileiros de Cardiologia (Online)instname:Sociedade Brasileira de Cardiologia (SBC)instacron:SBC10.5935/abc.20180058info:eu-repo/semantics/openAccessSalmazo,Péricles SidneiBazan,Silméia Garcia ZanatiShiraishi,Flávio GobbisBazan,RodrigoOkoshi,KatashiHueb,João Carloseng2018-05-30T00:00:00Zoai:scielo:S0066-782X2018000500402Revistahttp://www.arquivosonline.com.br/https://old.scielo.br/oai/scielo-oai.php||arquivos@cardiol.br1678-41700066-782Xopendoar:2018-05-30T00:00Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC)false
dc.title.none.fl_str_mv Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected Patients
title Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected Patients
spellingShingle Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected Patients
Salmazo,Péricles Sidnei
Atherosclerosis / complications
HIV
Cardiovascular Diseases / mortality
Carotid Intima Media Carotideo
Vascular Stiffness
Risk Factors
title_short Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected Patients
title_full Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected Patients
title_fullStr Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected Patients
title_full_unstemmed Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected Patients
title_sort Frequency of Subclinical Atherosclerosis in Brazilian HIV-Infected Patients
author Salmazo,Péricles Sidnei
author_facet Salmazo,Péricles Sidnei
Bazan,Silméia Garcia Zanati
Shiraishi,Flávio Gobbis
Bazan,Rodrigo
Okoshi,Katashi
Hueb,João Carlos
author_role author
author2 Bazan,Silméia Garcia Zanati
Shiraishi,Flávio Gobbis
Bazan,Rodrigo
Okoshi,Katashi
Hueb,João Carlos
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Salmazo,Péricles Sidnei
Bazan,Silméia Garcia Zanati
Shiraishi,Flávio Gobbis
Bazan,Rodrigo
Okoshi,Katashi
Hueb,João Carlos
dc.subject.por.fl_str_mv Atherosclerosis / complications
HIV
Cardiovascular Diseases / mortality
Carotid Intima Media Carotideo
Vascular Stiffness
Risk Factors
topic Atherosclerosis / complications
HIV
Cardiovascular Diseases / mortality
Carotid Intima Media Carotideo
Vascular Stiffness
Risk Factors
description Abstract Background: AIDS as well as atherosclerosis are important public health problems. The longer survival among HIV-infected is associated with increased number of cardiovascular events in this population, and this association is not fully understood. Objectives: To identify the frequency of subclinical atherosclerosis in HIV-infected patients compared to control subjects; to analyze associations between atherosclerosis and clinical and laboratory variables, cardiovascular risk factors, and the Framingham coronary heart disease risk score (FCRS). Methods: Prospective cross-sectional case-control study assessing the presence of subclinical atherosclerosis in 264 HIV-infected patients and 279 controls. Clinical evaluation included ultrasound examination of the carotid arteries, arterial stiffness by pulse wave velocity (PWV) and augmentation index (AIx), laboratory analysis of peripheral blood, and cardiovascular risk according to FCRS criteria. The significance level adopted in the statistical analysis was p < 0.05. Results: Plaques were found in 37% of the HIV group and 4% of controls (p < 0.001). Furthermore, carotid intima-media thickness was higher in the HIV group than in controls (p < 0.001). Patients with carotid plaque had higher fasting glucose, total cholesterol, low-density lipoprotein cholesterol, and triglycerides than those without plaques. The presence of HIV, adjusted for age, overweight/obesity, and smoking increased by almost fivefold the risk of atherosclerotic carotid plaque (OR: 4.9; 95%CI: 2.5-9.9; p < 0.001). Exposure to protease inhibitors did not influence carotid intima-media thickness, was not associated with carotid plaque frequency, and did not alter the mechanical characteristics of the arterial system (PWV and AIx). Conclusions: HIV-infected patients are at increased risk of atherosclerosis in association with classical cardiovascular risk factors. Treatment with protease inhibitors does not promote functional changes in the arteries, and shows no association with increased frequency of atherosclerotic plaques in carotid arteries. The FCRS may be inappropriate for this population.
publishDate 2018
dc.date.none.fl_str_mv 2018-05-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018000500402
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0066-782X2018000500402
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.5935/abc.20180058
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
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dc.publisher.none.fl_str_mv Sociedade Brasileira de Cardiologia - SBC
publisher.none.fl_str_mv Sociedade Brasileira de Cardiologia - SBC
dc.source.none.fl_str_mv Arquivos Brasileiros de Cardiologia v.110 n.5 2018
reponame:Arquivos Brasileiros de Cardiologia (Online)
instname:Sociedade Brasileira de Cardiologia (SBC)
instacron:SBC
instname_str Sociedade Brasileira de Cardiologia (SBC)
instacron_str SBC
institution SBC
reponame_str Arquivos Brasileiros de Cardiologia (Online)
collection Arquivos Brasileiros de Cardiologia (Online)
repository.name.fl_str_mv Arquivos Brasileiros de Cardiologia (Online) - Sociedade Brasileira de Cardiologia (SBC)
repository.mail.fl_str_mv ||arquivos@cardiol.br
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