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Prevalence of cardiovascular diseases in HIV-infected outpatients: results from a prospective, multicenter cohort study

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Abstract

Background

Recent studies suggest a rising rate of cardiovascular disease (CVD) in HIV-infected subjects. Although most countries have an aging HIV-infected population, there remains a lack of knowledge about associated cardiovascular diseases.

Methods

This ongoing prospective multicentre observational cohort study aims to elucidate CVD prevalence in HIV-infected outpatients by standardized non-invasive cardiovascular screening. Cardiovascular and coronary risk was calculated using Framingham risk scores.

Results

803 HIV-infected subjects (mean age 44.2 years, female 16.6 %) were included. The prevalence of CVD in HIV-infected subjects was 10.1 % (95 % CI 8.0–12.2 %). Aging HIV-infected patients (≥45 years, N = 348) exhibited significantly increased rates of CVD, including an elevated frequency of coronary artery disease (7.5 vs. 1.8 %, p < 0.001), myocardial infarction (6.0 vs. 1.8 %, p = 0.002) and peripheral arterial diseases (4.6 vs. 1.5 %, p < 0.017). Furthermore, aging patients exhibited a higher rate of chronic heart failure (5.2 vs. 1.5 %, p < 0.001), predominantly of ischemic etiology. In multivariate analyses, age (OR 2.05 per decade, 95 % CI 1.64–2.56), smoking (OR 5.96 per decade, 95 % CI 2.31–15.38) and advanced symptomatic HIV infection (OR 2.60 per decade, 95 % CI 1.31–5.15), were significantly associated with the prevalence of CVD. Based on the 10-year cardiovascular risk estimation, a disproportionate increase in cardiac events has to be expected in aging HIV-infected subjects in the next decades (≥45 years/<45 years 16.4 vs. 4.2 %, p < 0.001).

Conclusion

CVD in aging HIV-infected population is an increasing medical challenge. In the era of antiretroviral therapy, prevention and diagnostic strategies are essential to reduce the prevalence of CVD in HIV-infected patients.

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Acknowledgments

This work was supported by the Competence Network of Heart Failure funded by the Federal Ministry of Education and Research (BMBF), FKZ 01GI0205. It was further supported by members of the Competence Network for HIV/AIDS. The authors give their respect and thanks to all participating and supporting persons of the present study, including the staff of the recruiting centers, i.e. the team of Dr. Becker-Boost (Duisburg), Dr. Rudolph (Essen), Dr. Hower (Dortmund), Prof. Dr. Brockmeyer (Bochum), and Dr. Esser (Essen).

Conflict of interest

The authors declare that they have no potential conflicts of interest.

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Authors and Affiliations

  1. Department of Dermatology and Venerology, University Hospital Essen, University of Duisburg-Essen, Medical School, Hufelandstr. 55, 45122, Essen, Germany

    Stefan Esser & Dirk Schadendorf

  2. Clinical Trial Centre, University of Leipzig, Leipzig, Germany

    Götz Gelbrich

  3. Department of Cardiology, University Hospital Essen, University of Duisburg-Essen, Medical School, Hufelandstr. 55, 45122, Essen, Germany

    Raimund Erbel, Till Neumann & Nico Reinsch

  4. Department of Dermatology and HIV-Outpatient Department, Ruhr University Bochum, Gudrunstrasse 56, 44791, Bochum, Germany

    Norbert Brockmeyer

  5. Department of Global and International Health, Harvard School of Public Health, Boston, USA

    Alexander Goehler

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  1. Stefan Esser
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Corresponding author

Correspondence to Nico Reinsch.

Additional information

T. Neumann and N. Reinsch contributed equally to this work.

For the HIV-HEART Study Investigative Group and on behalf of the German Competence Network Heart Failure and the German Competence Network for HIV/AIDS.

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Esser, S., Gelbrich, G., Brockmeyer, N. et al. Prevalence of cardiovascular diseases in HIV-infected outpatients: results from a prospective, multicenter cohort study. Clin Res Cardiol 102, 203–213 (2013). https://doi.org/10.1007/s00392-012-0519-0

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  • DOI: https://doi.org/10.1007/s00392-012-0519-0

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