Evolving understanding of cardiovascular, cerebrovascular and peripheral arterial disease in people living with HIV and role of novel biomarkers. A study of the Spanish CoRIS cohort, 2004-2015
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Le résumé fourni par la source
OBJECTIVES: To analyze the incidence rates (IR) and spectrum of vascular events in people living with HIV (PLWH) in Spain from 2004 to 2015. Serial measurements of different plasma cardiovascular biomarkers were assessed in relation to disease development. METHODS: Longitudinal study in a nationwide contemporary multicenter cohort of PLWH. A nested case-control study was performed to evaluate the predictive value of cardiovascular biomarkers. Additive generalized and Cox mixed models were used for the analyses. RESULTS: 9,712 PLWH and 48,341 person-years of follow-up were analysed. During 2004-2015, 147 persons developed 154 vascular events; 80 (54.42%) coronary-related; 65 (44.22%) cerebrovascular-related, and 9 (6.12%) peripheral arterial disease. The 2004-2015 IR (95% confidence interval) of vascular events was 3.17 (2.69-3.71) x1,000 person-years; 1.64 (1.30-2.05) for coronary events; 1.34 (1.03-1.70) for cerebrovascular events; and 0.19 (0.09-0.35) for peripheral arterial disease (p<0.001). IR of vascular events gradually increased from 0.37 (0.12-0.85) x1,000 patient-years in the stratum 25-34-years to 19.65 (6.38-45.85) x1,000 patient-years in the stratum 75-84-years. Compared to the general population, there was a higher incidence of acute myocardial infarction (AMI) in men (sIR ratio 1.29 [95% CI 1.16-1.42]), of cerebrovascular events in women (sIR ratio 2.44 [95% CI 1.68-3.19]), and of both types of events specifically among the younger age-strata. CD4 count (hazard ratio 0.80, [95% CI, 0.79-0.81]), age (1.86 [1.47-2.34] for 45-65 years and 3.44 [2.37-4.97] for >65 years) and vascular event (1.81 [1.12-2.94]) were associated with total mortality. Adjusted levels of intercellular-adhesion-molecule (sICAM), pro-b-type-natriuretic-peptide (pro-BNP) and marginally sCD14, were higher among patients who subsequently developed vascular events. CONCLUSION: Vascular events in PLWH do preferentially occur in the older age-strata, they are associated with increased mortality and, compared to the general population, the excess risk occurs at younger ages. Peripheral arterial disease is unusual. Vascular events are preceded by increased levels of sICAM, pro-BNP and, marginally, sCD14.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Evolving understanding of cardiovascular, cerebrovascular and peripheral arterial disease in people living with HIV and role of novel biomarkers. A study of the Spanish CoRIS cohort, 2004-2015
- Date Crossref
- 26/04/2019
- Éditeur
- Public Library of Science (PLoS)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Universitat de Miguel Hernández d'Elx pays non établi dans la noticeUniversité ou école supérieure
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Hospital General Universitario de Elche Infectious Diseases Unit pays non établi dans la noticeÉtablissement de santé
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Hospital Universitario La Paz pays non établi dans la noticeÉtablissement de santé
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Institut de Recerca Biomèdica Catalunya Sud pays non établi dans la noticeStructure de recherche
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Hospital Universitari Joan XXIII de Tarragona pays non établi dans la noticeÉtablissement de santé
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Universitat Rovira i Virgili pays non établi dans la noticeUniversité ou école supérieure
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Complexo Hospitalario Universitario A Coruña pays non établi dans la noticeÉtablissement de santé
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Statistics pays non établi dans la noticeInstitution
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Hospital La Paz-Carlos III-Cantoblanco Infectious Diseases Unit pays non établi dans la noticeÉtablissement de santé
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Hospital La Fe Infectious Diseases Unit pays non établi dans la noticeÉtablissement de santé
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Hospital Universitari de Tarragona Joan XXIII Infectious Diseases Unit pays non établi dans la noticeÉtablissement de santé
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Complejo Hospitalario Universitario de A Coruña Infectious Diseses Unit pays non établi dans la noticeÉtablissement de santé
Universitat de Miguel Hernández d'Elx, Infectious Diseases Unit — Hospital General Universitario de Elche et Hospital Universitario La Paz, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.