Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento

Detalhes bibliográficos
Autor(a) principal: Burgos, Úrsula Maria Moreira Costa
Data de Publicação: 2019
Tipo de documento: Tese
Idioma: por
Título da fonte: Repositório Institucional da UFS
Texto Completo: http://ri.ufs.br/jspui/handle/riufs/13077
Resumo: Background. Nearly 37 million people living with the human immunodeficiency virus (HIV) and antiretroviral treatment have allowed the disease to become chronic, leading to the association of other conditions such as coronary artery disease (CAD). The use of the Coronary Artery Calcium Score (CACs) in this scenario may add information to risk stratification for CAD. Objectives. To evaluate HIV-positive patients by using CACs, compare it with that of patients without HIV and to evaluate factors associated with pathological CACs. Methods. Ninety-seven HIV/AIDS patients from the Infectious Diseases Outpatient Clinics of the University Hospital of the Federal University of Sergipe and the Sergipe Center for Medical Specialties were included in the study. They underwent a clinical and laboratory evaluation and coronary tomography for CACs evaluation. This sample was compared with a control group (composed of a seronegative patients database without previous cardiovascular disease). Results. Individuals with HIV / AIDS had a mean age of 46.9 ± 11.4 years vs. 55.5 ± 14.8 years in the control group (p <0.001) as well as had less hypertension (20.2% vs. 50.4 %; p <0.001) and diabetes (5.3% vs. 23.3%; p <0.001) than those not infected with HIV. On the other hand, both groups have the same EC level. In the adjusted odds ratio age (OR = 1.08; 95% CI = 0.98-1.17; p = 0.006), male gender (OR = 3.61; 95% CI = 1.06-12.30; p = 0.041) and use of protease inhibitors (PI) (OR = 3.38; 95% CI = 1.10-10.40; p = 0.033) are factors associated with coronary calcification. Most patients with HIV have undetectable viremia and high CD4 + counts, along with lipid profile disorders (total cholesterol> 200 mg / dl = 34.0 %, LDL cholesterol> 130 mg / dl = 28.9% and triglycerides > 150 mg / dl = 37.1%). Conclusion. Our findings suggest that HIV/AIDS and / or its treatment predisposes to coronary calcification, since even younger and with less classical risk factors, patients with HIV/AIDS have the same degree of coronary calcification as seronegative ones, being factors related to a higher chance of calcification age, male gender and PI use.
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spelling Burgos, Úrsula Maria Moreira CostaOliveira, Joselina Luzia Menezes2020-03-19T20:11:24Z2020-03-19T20:11:24Z2019-09-12BURGOS, Úrsula Maria Moreira Costa. Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento. 2019. 95 f. Tese (Doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2019.http://ri.ufs.br/jspui/handle/riufs/13077Background. Nearly 37 million people living with the human immunodeficiency virus (HIV) and antiretroviral treatment have allowed the disease to become chronic, leading to the association of other conditions such as coronary artery disease (CAD). The use of the Coronary Artery Calcium Score (CACs) in this scenario may add information to risk stratification for CAD. Objectives. To evaluate HIV-positive patients by using CACs, compare it with that of patients without HIV and to evaluate factors associated with pathological CACs. Methods. Ninety-seven HIV/AIDS patients from the Infectious Diseases Outpatient Clinics of the University Hospital of the Federal University of Sergipe and the Sergipe Center for Medical Specialties were included in the study. They underwent a clinical and laboratory evaluation and coronary tomography for CACs evaluation. This sample was compared with a control group (composed of a seronegative patients database without previous cardiovascular disease). Results. Individuals with HIV / AIDS had a mean age of 46.9 ± 11.4 years vs. 55.5 ± 14.8 years in the control group (p <0.001) as well as had less hypertension (20.2% vs. 50.4 %; p <0.001) and diabetes (5.3% vs. 23.3%; p <0.001) than those not infected with HIV. On the other hand, both groups have the same EC level. In the adjusted odds ratio age (OR = 1.08; 95% CI = 0.98-1.17; p = 0.006), male gender (OR = 3.61; 95% CI = 1.06-12.30; p = 0.041) and use of protease inhibitors (PI) (OR = 3.38; 95% CI = 1.10-10.40; p = 0.033) are factors associated with coronary calcification. Most patients with HIV have undetectable viremia and high CD4 + counts, along with lipid profile disorders (total cholesterol> 200 mg / dl = 34.0 %, LDL cholesterol> 130 mg / dl = 28.9% and triglycerides > 150 mg / dl = 37.1%). Conclusion. Our findings suggest that HIV/AIDS and / or its treatment predisposes to coronary calcification, since even younger and with less classical risk factors, patients with HIV/AIDS have the same degree of coronary calcification as seronegative ones, being factors related to a higher chance of calcification age, male gender and PI use.Introdução. Nos dias atuais quase 37 milhões de pessoas vivem com o vírus da imunodeficiência humana (HIV). O tratamento antirretroviral permitiu a cronificação da doença, dando espaço a associação de outras patologias como a doença arterial coronariana (DAC). O uso do Escore de Cálcio Coronário (EC) neste cenário pode auxiliar na estratificação de risco para DAC. Objetivos. Avaliar portadores de HIV/AIDS com o uso do EC, comparar com o de pacientes sem HIV/AIDS e avaliar fatores associados com escore de cálcio patológico na população investigada. Métodos. Foram incluídos 97 portadores de HIV/AIDS provenientes dos ambulatórios de Infectologia do Hospital Universitário da Universidade Federal de Sergipe e do Centro de Especialidades Médicas de Sergipe, submetidos a avaliação clínico-laboratorial e tomografia de coronárias para avaliação de EC. Esta amostra foi comparada com um grupo controle (composto por banco de dados de pacientes soronegativos e sem doença cardiovascular prévia). Resultados. Indivíduos com HIV / AIDS apresentam idade média de 46,9 ± 11,4 anos vs 55,5 ± 14,8 anos do grupo controle (p <0,001) assim como menor probabilidade de ter hipertensão arterial(20,2% vs 50,4%; p <0,001) e diabetes mellitus(5,3% vs 23,3 %; p <0,001) do que os não infectados pelo HIV. Por outro lado, ambos os grupos têm o mesmo nível de EC. Na razão de chances ajustada, idade (RC = 1,08; IC95% = 0,98-1,17; p =0,006), sexo masculino (RC = 3,61; IC95% = 1,06-12,30; p =0,041) e uso de inibidores de protease (IP) (RC = 3,38; IC95% = 1,10-10,40; p =0,033) são fatores associados à calcificação coronariana. A maioria dos pacientes com HIV apresenta viremia indetectável e alta contagem de CD4 +, paralelamente a distúrbios do perfil lipídico (colesterol total> 200 mg / dl = 34,0%, colesterol LDL> 130 mg / dl = 28,9% e triglicerídeos> 150 mg / dl = 37,1%). Conclusão. Nossos achados sugerem a infecção por HIV/AIDS e/ou seu tratamento predispõe à calcificação coronariana já que mesmo mais jovens e com menos fatores de risco clássicos, pacientes com HIV/AIDS apresentam o mesmo grau de calcificação coronariana que os soronegativos, sendo fatores relacionados a uma maior chance de calcificação idade, sexo masculino e uso de IP.AracajuporDoenças cardíacasAIDSHIV-positivoPacientes de AIDSHIVAterosclerose coronáriaEscore de cálcio coronarianoCoronary atherosclerosisCoronary calcium scoreCIENCIAS DA SAUDEEscore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamentoCoronary Artery Calcium Score in HIV/AIDS Cardiovascular Risk Stratificationinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisPós-Graduação em Ciências da SaúdeUniversidade Federal de Sergipereponame:Repositório Institucional da UFSinstname:Universidade Federal de Sergipe (UFS)instacron:UFSinfo:eu-repo/semantics/openAccessORIGINALURSULA_MARIA_MOREIRA_COSTA_BURGOS.pdfURSULA_MARIA_MOREIRA_COSTA_BURGOS.pdfapplication/pdf3047129https://ri.ufs.br/jspui/bitstream/riufs/13077/2/URSULA_MARIA_MOREIRA_COSTA_BURGOS.pdf0f20964ffe39235a73418751c535a0baMD52TEXTURSULA_MARIA_MOREIRA_COSTA_BURGOS.pdf.txtURSULA_MARIA_MOREIRA_COSTA_BURGOS.pdf.txtExtracted texttext/plain122053https://ri.ufs.br/jspui/bitstream/riufs/13077/4/URSULA_MARIA_MOREIRA_COSTA_BURGOS.pdf.txt97d1295b2c6eaf9e9d8abfdd514e5affMD54THUMBNAILURSULA_MARIA_MOREIRA_COSTA_BURGOS.pdf.jpgURSULA_MARIA_MOREIRA_COSTA_BURGOS.pdf.jpgGenerated Thumbnailimage/jpeg1284https://ri.ufs.br/jspui/bitstream/riufs/13077/5/URSULA_MARIA_MOREIRA_COSTA_BURGOS.pdf.jpg11f4fe6b0289868b49f2dc4765d2543bMD55LICENSElicense.txtlicense.txttext/plain; charset=utf-81475https://ri.ufs.br/jspui/bitstream/riufs/13077/3/license.txt098cbbf65c2c15e1fb2e49c5d306a44cMD53riufs/130772020-03-19 17:11:24.668oai:ufs.br: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Repositório InstitucionalPUBhttps://ri.ufs.br/oai/requestrepositorio@academico.ufs.bropendoar:2020-03-19T20:11:24Repositório Institucional da UFS - Universidade Federal de Sergipe (UFS)false
dc.title.pt_BR.fl_str_mv Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento
dc.title.alternative.eng.fl_str_mv Coronary Artery Calcium Score in HIV/AIDS Cardiovascular Risk Stratification
title Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento
spellingShingle Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento
Burgos, Úrsula Maria Moreira Costa
Doenças cardíacas
AIDS
HIV-positivo
Pacientes de AIDS
HIV
Aterosclerose coronária
Escore de cálcio coronariano
Coronary atherosclerosis
Coronary calcium score
CIENCIAS DA SAUDE
title_short Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento
title_full Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento
title_fullStr Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento
title_full_unstemmed Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento
title_sort Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento
author Burgos, Úrsula Maria Moreira Costa
author_facet Burgos, Úrsula Maria Moreira Costa
author_role author
dc.contributor.author.fl_str_mv Burgos, Úrsula Maria Moreira Costa
dc.contributor.advisor1.fl_str_mv Oliveira, Joselina Luzia Menezes
contributor_str_mv Oliveira, Joselina Luzia Menezes
dc.subject.por.fl_str_mv Doenças cardíacas
AIDS
HIV-positivo
Pacientes de AIDS
HIV
Aterosclerose coronária
Escore de cálcio coronariano
topic Doenças cardíacas
AIDS
HIV-positivo
Pacientes de AIDS
HIV
Aterosclerose coronária
Escore de cálcio coronariano
Coronary atherosclerosis
Coronary calcium score
CIENCIAS DA SAUDE
dc.subject.eng.fl_str_mv Coronary atherosclerosis
Coronary calcium score
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE
description Background. Nearly 37 million people living with the human immunodeficiency virus (HIV) and antiretroviral treatment have allowed the disease to become chronic, leading to the association of other conditions such as coronary artery disease (CAD). The use of the Coronary Artery Calcium Score (CACs) in this scenario may add information to risk stratification for CAD. Objectives. To evaluate HIV-positive patients by using CACs, compare it with that of patients without HIV and to evaluate factors associated with pathological CACs. Methods. Ninety-seven HIV/AIDS patients from the Infectious Diseases Outpatient Clinics of the University Hospital of the Federal University of Sergipe and the Sergipe Center for Medical Specialties were included in the study. They underwent a clinical and laboratory evaluation and coronary tomography for CACs evaluation. This sample was compared with a control group (composed of a seronegative patients database without previous cardiovascular disease). Results. Individuals with HIV / AIDS had a mean age of 46.9 ± 11.4 years vs. 55.5 ± 14.8 years in the control group (p <0.001) as well as had less hypertension (20.2% vs. 50.4 %; p <0.001) and diabetes (5.3% vs. 23.3%; p <0.001) than those not infected with HIV. On the other hand, both groups have the same EC level. In the adjusted odds ratio age (OR = 1.08; 95% CI = 0.98-1.17; p = 0.006), male gender (OR = 3.61; 95% CI = 1.06-12.30; p = 0.041) and use of protease inhibitors (PI) (OR = 3.38; 95% CI = 1.10-10.40; p = 0.033) are factors associated with coronary calcification. Most patients with HIV have undetectable viremia and high CD4 + counts, along with lipid profile disorders (total cholesterol> 200 mg / dl = 34.0 %, LDL cholesterol> 130 mg / dl = 28.9% and triglycerides > 150 mg / dl = 37.1%). Conclusion. Our findings suggest that HIV/AIDS and / or its treatment predisposes to coronary calcification, since even younger and with less classical risk factors, patients with HIV/AIDS have the same degree of coronary calcification as seronegative ones, being factors related to a higher chance of calcification age, male gender and PI use.
publishDate 2019
dc.date.issued.fl_str_mv 2019-09-12
dc.date.accessioned.fl_str_mv 2020-03-19T20:11:24Z
dc.date.available.fl_str_mv 2020-03-19T20:11:24Z
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dc.identifier.citation.fl_str_mv BURGOS, Úrsula Maria Moreira Costa. Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento. 2019. 95 f. Tese (Doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2019.
dc.identifier.uri.fl_str_mv http://ri.ufs.br/jspui/handle/riufs/13077
identifier_str_mv BURGOS, Úrsula Maria Moreira Costa. Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento. 2019. 95 f. Tese (Doutorado em Ciências da Saúde) – Universidade Federal de Sergipe, Aracaju, 2019.
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