| Subclinical carotid atherosclerosis in HIV-infected patients: role of combination antiretroviral therapy. | |
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MedLine Citation:
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PMID: 16439699 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Whether or not combination antiretroviral therapy (CART) alone directly contributes to accelerating atherosclerosis in HIV-infected patients has not been studied in depth. This study aimed to ascertain the relationship between this therapy and subclinical carotid atherosclerosis according to cardiovascular risk. METHODS: Sixty-eight HIV-infected patients with < or =1 cardiovascular risk factors and 64 with > or =2 risk factors completed the study protocol consisting of clinical, laboratory, and vascular evaluation by carotid high-resolution B-mode ultrasonography. Univariate and multivariate logistic regression analyses were performed with the presence of subclinical carotid atherosclerosis, defined by carotid intima-media thickness >0.8 mm or the presence of plaque being the dependent variable. RESULTS: Among the 132 enrolled patients, 93 (70.5%) were on CART and 39 (29.5%) had never been on antiretroviral therapy. In accordance with cardiovascular risk stratification, subclinical carotid atherosclerosis was found in 26.6% (17 of 64 patients) of the very low-risk group (10-year coronary risk <5%), 35.3% (12 of 34 patients) of the low-risk group (10-year coronary risk between 5% and 9%) and 76.5% (26 of 34 patients) of the moderate/high-risk group (10-year coronary risk > or =10%). Thus, 55 (41.7%) of the 132 HIV-infected patients had subclinical carotid atherosclerosis, and independent variables associated with carotid atherosclerosis (odds ratio; 95% CI) were: CART exposure (10.5; 2.8 to 39) and 10-year coronary risk > or =10% (4.2; 1.5 to 12). In very low coronary risk patients (<5%), age (per 10-year increment: 4.01; 1.12 to 14.38), systolic blood pressure (per unit mm Hg 1.07; 1.01 to 1.14), and CART exposure (8.65; 1.54 to 48.54) were independently associated with subclinical carotid atherosclerosis. CONCLUSIONS: CART should be considered a strong, independent predictor for the development of subclinical atherosclerosis in HIV-infected patients, regardless of known major cardiovascular risk factors and atherogenic metabolic abnormalities induced by this therapy. |
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Authors:
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Carlos Jericó; Hernando Knobel; Nahum Calvo; María L Sorli; Ana Guelar; Juan L Gimeno-Bayón; Pere Saballs; José L López-Colomés; Juan Pedro-Botet |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2006-01-26 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 37 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2006 Mar |
Date Detail:
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Created Date: 2006-02-28 Completed Date: 2006-03-23 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 812-7 Citation Subset: IM |
Affiliation:
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Department of Medicine, Hospital del Mar, Barcelona, Spain. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Retroviral Agents
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therapeutic use* Atherosclerosis Blood Pressure Cardiovascular Diseases / pathology Carotid Artery Diseases / complications*, diagnosis* Cholesterol / metabolism Drug Therapy, Combination Female HIV Infections / complications*, diagnosis, drug therapy* HIV Seropositivity / drug therapy* Humans Logistic Models Male Models, Statistical Multivariate Analysis Odds Ratio Risk Risk Factors Time Factors Ultrasonography |
| Chemical | |
Reg. No./Substance:
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0/Anti-Retroviral Agents; 57-88-5/Cholesterol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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