OBJECTIVES: To study the relationship between exposure to protease inhibitor (PI) therapy and increased risk of cardiovascular events in HIV-infected patients. METHODS: We estimated the risk of cardiovascular disease (CVD) events with PI exposure in a cohort of HIV-infected patients using a time-dependent Cox proportional hazards model adjusting for the major CVD risk factors. Only the first CVD event for each subject was counted. RESULTS: Of a total of 7542 patients, 77% were exposed to PIs. CVD event rates were 9.8/1000 and 6.5/1000 person-years of follow-up (PYFU) in the PI-exposed and nonexposed groups, respectively (P=0.0008). PI exposure >/=60 days was associated with an increased risk of CVD event [adjusted hazards ratio (HR(adj)) 1.71; 95% confidence interval (CI) 1.08-2.74; P=0.03]. Results from a subgroup of patients aged between 35 and 65 years were similar (HR(adj) 1.90; 95% CI 1.13-3.20; P=0.02). Other significant risk factors included smoking status, age, hypertension, diabetes mellitus and pre-existing CVD. CONCLUSIONS: Patients exposed to PI therapy had an increased risk of CVD events. Clinicians should evaluate the risk of CVD when making treatment decisions for HIV-infected patients.
OBJECTIVES: To study the relationship between exposure to protease inhibitor (PI) therapy and increased risk of cardiovascular events in HIV-infectedpatients. METHODS: We estimated the risk of cardiovascular disease (CVD) events with PI exposure in a cohort of HIV-infectedpatients using a time-dependent Cox proportional hazards model adjusting for the major CVD risk factors. Only the first CVD event for each subject was counted. RESULTS: Of a total of 7542 patients, 77% were exposed to PIs. CVD event rates were 9.8/1000 and 6.5/1000 person-years of follow-up (PYFU) in the PI-exposed and nonexposed groups, respectively (P=0.0008). PI exposure >/=60 days was associated with an increased risk of CVD event [adjusted hazards ratio (HR(adj)) 1.71; 95% confidence interval (CI) 1.08-2.74; P=0.03]. Results from a subgroup of patients aged between 35 and 65 years were similar (HR(adj) 1.90; 95% CI 1.13-3.20; P=0.02). Other significant risk factors included smoking status, age, hypertension, diabetes mellitus and pre-existing CVD. CONCLUSIONS:Patients exposed to PI therapy had an increased risk of CVD events. Clinicians should evaluate the risk of CVD when making treatment decisions for HIV-infectedpatients.
Authors: Morris Schambelan; Peter W F Wilson; Kevin E Yarasheski; W Todd Cade; Victor G Dávila-Román; Ralph B D'Agostino; Tarek A Helmy; Matthew Law; Kristin E Mondy; Sharon Nachman; Linda R Peterson; Signe W Worm Journal: Circulation Date: 2008-06-19 Impact factor: 29.690
Authors: Steven K Grinspoon; Carl Grunfeld; Donald P Kotler; Judith S Currier; Jens D Lundgren; Michael P Dubé; Steven E Lipshultz; Priscilla Y Hsue; Kathleen Squires; Morris Schambelan; Peter W F Wilson; Kevin E Yarasheski; Colleen M Hadigan; James H Stein; Robert H Eckel Journal: Circulation Date: 2008-06-19 Impact factor: 29.690
Authors: Judith S Currier; Jens D Lundgren; Andrew Carr; Daniel Klein; Caroline A Sabin; Paul E Sax; Jeffrey T Schouten; Marek Smieja Journal: Circulation Date: 2008-06-19 Impact factor: 29.690
Authors: Elizabeth George; Gregory M Lucas; Girish N Nadkarni; Derek M Fine; Richard Moore; Mohamed G Atta Journal: AIDS Date: 2010-01-28 Impact factor: 4.177