Escore de cálcio coronário na estratificação do risco cardiovascular de portadores de HIV/AIDS em tratamento
Autor(a) principal: | |
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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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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 |
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2020-03-19T20:11:24Z |
dc.date.available.fl_str_mv |
2020-03-19T20:11:24Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
status_str |
publishedVersion |
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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http://ri.ufs.br/jspui/handle/riufs/13077 |
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por |
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por |
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Pós-Graduação em Ciências da Saúde |
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Universidade Federal de Sergipe |
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