|
8th Annual Conference Of The British HIV Association [BHIVA]19 – 21 April 2002, University of York, York |
[AUTHOR(S):] J Whetham, AM Smith, IG Williams
Royal Free and University College Medical School, London
BHIVA Conf 2002 Apr 19-21;8:P1
BACKGROUND: Coronary heart disease (CHD) has been reported in HIV-positive patients treated with antiretroviral therapy. Hyperlipidaemia, diabetes mellitus (DM) and hypertension (HT) are associated with protease inhibitor (PI) treatment. These complications may increase the future incidence of CHD in this patient population. Risk calculation formulae are available to calculate 10-year risks for individuals.
METHODS: Data on patients receiving a PI-containing regimen were obtained from notes and a case report form. Data were collected on age, blood pressure (BP), cigarette smoking, plasma lipids, DM, previous CHD and family history of CHD. The Joint British Societies Cardiac Risk Assessor (Heart. 1998 Dec;80 Suppl 2:S1-29) was used to calculate the estimated 10-year risk of fatal and non-fatal myocardial infarction for each individual.
RESULTS: Data were available in 204 patients, median age 41 years (range 17-65), median CD4 count 390 cells/µL (range 10-1,180); 85% (n=174) had undergone PI treatment for over 6 months. Calculations were validated for 170 patients (excluding seven with CHD, 10 on cholesterol/BP treatment and 17 aged <32 years). The estimated proportion with a 10-year CHD risk of 15–30% was 14% (n=24), and >30% had 2% (n=3).
CONCLUSIONS: 16% of our patient population on a PI-containing regimen had a high 10-year risk of CHD. The contribution of PIassociated metabolic abnormalities to CHD risk is uncertain, as is the impact it has on the incidence of CHD over time compared with a general adult population of the same age range. Clinicians should be aware that national guidelines suggest that individuals with a 10-year risk >15% should be targeted for risk modification.
PRESENTING AUTHOR: AM Smith
020419
P1
Copyright © 2002 - British HIV Association (BHIVA) Reproduction of this abstract (other than one copy for personal reference) must be cleared through the BHIVA Organising Secretariat 1 Mountview Court, 310 Friern Barnet Lane, London N20 0LD