Giuseppe Vittorio De Socio1, Elena Ricci2, Giustino Parruti3, Leonardo Calza4, Paolo Maggi5, Benedetto Maurizio Celesia6, Giancarlo Orofino7, Giordano Madeddu8, Canio Martinelli9, Barbara Menzaghi10, Lucia Taramasso11, Giovanni Penco12, Laura Carenzi2, Marco Franzetti13, Paolo Bonfanti14. 1. Clinica di Malattie Infettive, Azienda Ospedaliero-Universitaria di Perugia, Piazzale Menghini 1, 06129, Perugia, Italy. giuseppedesocio@yahoo.it. 2. Department of Infectious Diseases, Luigi Sacco Hospital, Milan, Italy. 3. Department of Infectious Diseases, Pescara Hospital, Pescara, Italy. 4. Infectious Diseases Clinic, University of Bologna, Bologna, Italy. 5. Unit of Infectious Diseases, University of Bari, Bari, Italy. 6. Unit of Infectious Diseases, Garibaldi Hospital, University of Catania, Catania, Italy. 7. Department of Infectious Diseases, Amedeo di Savoia Hospital, Turin, Italy. 8. Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy. 9. Department of Infectious Diseases, Careggi Hospital, Florence, Italy. 10. Unit of Infectious Diseases, Busto Arsizio Hospital, Busto Arsizio, Italy. 11. Infectious Diseases, Hospital University San Martino Genoa, Genoa, Italy. 12. Department of Infectious Diseases, Galliera Hospital, Genoa, Italy. 13. Unit of Infectious Diseases, University of Milan, Milan, Italy. 14. Unit of Infectious Diseases, Manzoni Hospital, Lecco, Italy.
Abstract
OBJECTIVES: To investigate the use of statins and acetylsalicylic acid (ASA) in HIV people in clinical practice. DESIGN: A multicenter, nationwide, prospective cohort study, including 1182 consecutive HIV patients was conducted. METHODS: Statin and ASA prescription was evaluated in primary and secondary cardiovascular disease prevention, according to the European AIDS Clinical Society (EACS) guidelines. RESULTS: Followed-up patients (998) were mostly males (70.9 %) with a mean age at enrolment of 46.5 years (SD 9.5). The mean time of follow-up was 3.3 years (SD 0.8). At the last follow-up visit, statins would have been recommended for 31.2 % and ASA for 16 % by EACS guidelines. Conversely, only 15.6 and 7.6 % of patients were on statin and ASA treatment, respectively; only 50.3 % of patients treated with statins achieved recommended low-density lipoprotein cholesterol (LDL-c) levels. At the last follow-up visit, agreement between statin therapy and EACS recommendation was 0.58 (95 % CI 0.52-0.63). The corresponding figure for ASA therapy was 0.50 (95 % CI 0.42-0.58), whereas the agreement for ASA therapy in secondary prevention was 0.59 (95 % CI 0.50-0.68). CONCLUSIONS: The prescription of statins and ASA in HIV-infected patients remains largely suboptimal, as only about 50 % of patients requiring statins and ASA are properly treated. Higher attention on this relevant issue and further investigation are warranted in this at risk population.
OBJECTIVES: To investigate the use of statins and acetylsalicylic acid (ASA) in HIV people in clinical practice. DESIGN: A multicenter, nationwide, prospective cohort study, including 1182 consecutive HIVpatients was conducted. METHODS: Statin and ASA prescription was evaluated in primary and secondary cardiovascular disease prevention, according to the European AIDS Clinical Society (EACS) guidelines. RESULTS: Followed-up patients (998) were mostly males (70.9 %) with a mean age at enrolment of 46.5 years (SD 9.5). The mean time of follow-up was 3.3 years (SD 0.8). At the last follow-up visit, statins would have been recommended for 31.2 % and ASA for 16 % by EACS guidelines. Conversely, only 15.6 and 7.6 % of patients were on statin and ASA treatment, respectively; only 50.3 % of patients treated with statins achieved recommended low-density lipoprotein cholesterol (LDL-c) levels. At the last follow-up visit, agreement between statin therapy and EACS recommendation was 0.58 (95 % CI 0.52-0.63). The corresponding figure for ASA therapy was 0.50 (95 % CI 0.42-0.58), whereas the agreement for ASA therapy in secondary prevention was 0.59 (95 % CI 0.50-0.68). CONCLUSIONS: The prescription of statins and ASA in HIV-infectedpatients remains largely suboptimal, as only about 50 % of patients requiring statins and ASA are properly treated. Higher attention on this relevant issue and further investigation are warranted in this at risk population.
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