Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro

Rodrigo Carvalho Moreira; Mariana Alencar Miranda; Jessica Muller; Sandra Wagner Cardoso; Ronaldo Ismerio Moreira; Estevao Nunes; Rosane Griep; Maria Jesus Fonseca; Valdilea Veloso; Beatriz Grinsztejn; Dora Chor; Antonio Guilherme Pacheco

doi:doi:10.11648/j.ijidt.20210601.13

Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro

Rodrigo Carvalho Moreira, Mariana Alencar Miranda, Jessica Muller, Sandra Wagner Cardoso, Ronaldo Ismerio Moreira, Estevao Nunes, Rosane Griep, Maria Jesus Fonseca, Valdilea Veloso, Beatriz Grinsztejn, Dora Chor, Antonio Guilherme Pacheco

Published in International Journal of Infectious Diseases and Therapy (Volume 6, Issue 1)

Received: 22 January 2021 Accepted: 30 January 2021 Published: 9 February 2021

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Abstract

Background: Cardiovascular events (CVEs) have emerged as an important cause of morbimortality in people living with HIV/AIDS (PLHA). We aimed to investigate factors associated with incident CVE and compare the observed incidence with the predicted CVE risk by three different equations. Methods: Among the 649 active participants of the INI-ELSA cohort, we analysed data of 644 individuals free of CVE at baseline examinations. We used Cox regression models to study factors associated with CVE and to assess the equation's performance we compared the observed incidence with the overall 5-year predicted risks. Results: Over a median follow-up of 6.26-years (interquartile range [IQR] 6.01-6.47), there were 18 CVE, four deaths. Overall, 57.92% were male, median age was 43.4 years (35.82-50.73), most were on cART (88.65%). Participants who had CVE were older, had poorer renal function, higher proportion of dyslipidemia and higher levels of systolic blood pressure and triglycerides. The observed CVE rate was 2.90% (1.60-4.90%) whereas their overall cardiovascular disease (CVD) risk differed depending on which score was used: 0.91 (0.42-20), 1.16 (0.38-2.78) and 1.68 (0.60-3.87), according to Framingham, ASCVD and DAD, respectively. In the multivariable Cox analysis black race, smoking 10+ packs years, dyslipidemia, current CD4 cell count x10¹, cumulative viral load and time on NNRTI were independent predictors of CVE. Conclusion: Both traditional and HIV-related factors were associated with incident CVE. Risk scores were inconsistent in classifying patients who had CVE as high risk, indicating that validation studies are required to improve risk assessment of PLHA in Brazil.

Published in	International Journal of Infectious Diseases and Therapy (Volume 6, Issue 1)
DOI	10.11648/j.ijidt.20210601.13
Page(s)	17-26
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Acquired Immunodeficiency Syndrome, Cardiovascular Disease, Risk Assessment

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Rodrigo Carvalho Moreira, Mariana Alencar Miranda, Jessica Muller, Sandra Wagner Cardoso, Ronaldo Ismerio Moreira, et al. (2021). Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro. International Journal of Infectious Diseases and Therapy, 6(1), 17-26. https://doi.org/10.11648/j.ijidt.20210601.13

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Rodrigo Carvalho Moreira; Mariana Alencar Miranda; Jessica Muller; Sandra Wagner Cardoso; Ronaldo Ismerio Moreira, et al. Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro. Int. J. Infect. Dis. Ther. 2021, 6(1), 17-26. doi: 10.11648/j.ijidt.20210601.13

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Rodrigo Carvalho Moreira, Mariana Alencar Miranda, Jessica Muller, Sandra Wagner Cardoso, Ronaldo Ismerio Moreira, et al. Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro. Int J Infect Dis Ther. 2021;6(1):17-26. doi: 10.11648/j.ijidt.20210601.13

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@article{10.11648/j.ijidt.20210601.13,
  author = {Rodrigo Carvalho Moreira and Mariana Alencar Miranda and Jessica Muller and Sandra Wagner Cardoso and Ronaldo Ismerio Moreira and Estevao Nunes and Rosane Griep and Maria Jesus Fonseca and Valdilea Veloso and Beatriz Grinsztejn and Dora Chor and Antonio Guilherme Pacheco},
  title = {Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {6},
  number = {1},
  pages = {17-26},
  doi = {10.11648/j.ijidt.20210601.13},
  url = {https://doi.org/10.11648/j.ijidt.20210601.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20210601.13},
  abstract = {Background: Cardiovascular events (CVEs) have emerged as an important cause of morbimortality in people living with HIV/AIDS (PLHA). We aimed to investigate factors associated with incident CVE and compare the observed incidence with the predicted CVE risk by three different equations. Methods: Among the 649 active participants of the INI-ELSA cohort, we analysed data of 644 individuals free of CVE at baseline examinations. We used Cox regression models to study factors associated with CVE and to assess the equation's performance we compared the observed incidence with the overall 5-year predicted risks. Results: Over a median follow-up of 6.26-years (interquartile range [IQR] 6.01-6.47), there were 18 CVE, four deaths. Overall, 57.92% were male, median age was 43.4 years (35.82-50.73), most were on cART (88.65%). Participants who had CVE were older, had poorer renal function, higher proportion of dyslipidemia and higher levels of systolic blood pressure and triglycerides. The observed CVE rate was 2.90% (1.60-4.90%) whereas their overall cardiovascular disease (CVD) risk differed depending on which score was used: 0.91 (0.42-20), 1.16 (0.38-2.78) and 1.68 (0.60-3.87), according to Framingham, ASCVD and DAD, respectively. In the multivariable Cox analysis black race, smoking 10+ packs years, dyslipidemia, current CD4 cell count x101, cumulative viral load and time on NNRTI were independent predictors of CVE. Conclusion: Both traditional and HIV-related factors were associated with incident CVE. Risk scores were inconsistent in classifying patients who had CVE as high risk, indicating that validation studies are required to improve risk assessment of PLHA in Brazil.},
 year = {2021}
}

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TY  - JOUR
T1  - Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro
AU  - Rodrigo Carvalho Moreira
AU  - Mariana Alencar Miranda
AU  - Jessica Muller
AU  - Sandra Wagner Cardoso
AU  - Ronaldo Ismerio Moreira
AU  - Estevao Nunes
AU  - Rosane Griep
AU  - Maria Jesus Fonseca
AU  - Valdilea Veloso
AU  - Beatriz Grinsztejn
AU  - Dora Chor
AU  - Antonio Guilherme Pacheco
Y1  - 2021/02/09
PY  - 2021
N1  - https://doi.org/10.11648/j.ijidt.20210601.13
DO  - 10.11648/j.ijidt.20210601.13
T2  - International Journal of Infectious Diseases and Therapy
JF  - International Journal of Infectious Diseases and Therapy
JO  - International Journal of Infectious Diseases and Therapy
SP  - 17
EP  - 26
PB  - Science Publishing Group
SN  - 2578-966X
UR  - https://doi.org/10.11648/j.ijidt.20210601.13
AB  - Background: Cardiovascular events (CVEs) have emerged as an important cause of morbimortality in people living with HIV/AIDS (PLHA). We aimed to investigate factors associated with incident CVE and compare the observed incidence with the predicted CVE risk by three different equations. Methods: Among the 649 active participants of the INI-ELSA cohort, we analysed data of 644 individuals free of CVE at baseline examinations. We used Cox regression models to study factors associated with CVE and to assess the equation's performance we compared the observed incidence with the overall 5-year predicted risks. Results: Over a median follow-up of 6.26-years (interquartile range [IQR] 6.01-6.47), there were 18 CVE, four deaths. Overall, 57.92% were male, median age was 43.4 years (35.82-50.73), most were on cART (88.65%). Participants who had CVE were older, had poorer renal function, higher proportion of dyslipidemia and higher levels of systolic blood pressure and triglycerides. The observed CVE rate was 2.90% (1.60-4.90%) whereas their overall cardiovascular disease (CVD) risk differed depending on which score was used: 0.91 (0.42-20), 1.16 (0.38-2.78) and 1.68 (0.60-3.87), according to Framingham, ASCVD and DAD, respectively. In the multivariable Cox analysis black race, smoking 10+ packs years, dyslipidemia, current CD4 cell count x101, cumulative viral load and time on NNRTI were independent predictors of CVE. Conclusion: Both traditional and HIV-related factors were associated with incident CVE. Risk scores were inconsistent in classifying patients who had CVE as high risk, indicating that validation studies are required to improve risk assessment of PLHA in Brazil.
VL  - 6
IS  - 1
ER  -

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Author Information

Rodrigo Carvalho Moreira

Oswaldo Cruz Foundation, Scientific Computing Program, Rio de Janeiro, Brazil
Mariana Alencar Miranda

Internal Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Jessica Muller

Internal Medicine, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Sandra Wagner Cardoso

Oswaldo Cruz Foundation, National Institute of Infectology Evandro Chagas, Rio de Janeiro, Brazil
Ronaldo Ismerio Moreira

Oswaldo Cruz Foundation, National Institute of Infectology Evandro Chagas, Rio de Janeiro, Brazil
Estevao Nunes

Oswaldo Cruz Foundation, National Institute of Infectology Evandro Chagas, Rio de Janeiro, Brazil
Rosane Griep

Oswaldo Cruz Foundation, Laboratory of Health and Environment Education, Rio de Janeiro, Brazil
Maria Jesus Fonseca

Oswaldo Cruz Foundation, Department of Epidemiology and Quantitative Methods in Health, Rio de Janeiro, Brazil
Valdilea Veloso

Oswaldo Cruz Foundation, National Institute of Infectology Evandro Chagas, Rio de Janeiro, Brazil
Beatriz Grinsztejn

Oswaldo Cruz Foundation, National Institute of Infectology Evandro Chagas, Rio de Janeiro, Brazil
Dora Chor

Oswaldo Cruz Foundation, Department of Epidemiology and Quantitative Methods in Health, Rio de Janeiro, Brazil
Antonio Guilherme Pacheco

Oswaldo Cruz Foundation, Scientific Computing Program, Rio de Janeiro, Brazil

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Rodrigo Carvalho Moreira, Mariana Alencar Miranda, Jessica Muller, Sandra Wagner Cardoso, Ronaldo Ismerio Moreira, et al. (2021). Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro. International Journal of Infectious Diseases and Therapy, 6(1), 17-26. https://doi.org/10.11648/j.ijidt.20210601.13

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Rodrigo Carvalho Moreira; Mariana Alencar Miranda; Jessica Muller; Sandra Wagner Cardoso; Ronaldo Ismerio Moreira, et al. Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro. Int. J. Infect. Dis. Ther. 2021, 6(1), 17-26. doi: 10.11648/j.ijidt.20210601.13

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Rodrigo Carvalho Moreira, Mariana Alencar Miranda, Jessica Muller, Sandra Wagner Cardoso, Ronaldo Ismerio Moreira, et al. Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro. Int J Infect Dis Ther. 2021;6(1):17-26. doi: 10.11648/j.ijidt.20210601.13

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@article{10.11648/j.ijidt.20210601.13,
  author = {Rodrigo Carvalho Moreira and Mariana Alencar Miranda and Jessica Muller and Sandra Wagner Cardoso and Ronaldo Ismerio Moreira and Estevao Nunes and Rosane Griep and Maria Jesus Fonseca and Valdilea Veloso and Beatriz Grinsztejn and Dora Chor and Antonio Guilherme Pacheco},
  title = {Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro},
  journal = {International Journal of Infectious Diseases and Therapy},
  volume = {6},
  number = {1},
  pages = {17-26},
  doi = {10.11648/j.ijidt.20210601.13},
  url = {https://doi.org/10.11648/j.ijidt.20210601.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijidt.20210601.13},
  abstract = {Background: Cardiovascular events (CVEs) have emerged as an important cause of morbimortality in people living with HIV/AIDS (PLHA). We aimed to investigate factors associated with incident CVE and compare the observed incidence with the predicted CVE risk by three different equations. Methods: Among the 649 active participants of the INI-ELSA cohort, we analysed data of 644 individuals free of CVE at baseline examinations. We used Cox regression models to study factors associated with CVE and to assess the equation's performance we compared the observed incidence with the overall 5-year predicted risks. Results: Over a median follow-up of 6.26-years (interquartile range [IQR] 6.01-6.47), there were 18 CVE, four deaths. Overall, 57.92% were male, median age was 43.4 years (35.82-50.73), most were on cART (88.65%). Participants who had CVE were older, had poorer renal function, higher proportion of dyslipidemia and higher levels of systolic blood pressure and triglycerides. The observed CVE rate was 2.90% (1.60-4.90%) whereas their overall cardiovascular disease (CVD) risk differed depending on which score was used: 0.91 (0.42-20), 1.16 (0.38-2.78) and 1.68 (0.60-3.87), according to Framingham, ASCVD and DAD, respectively. In the multivariable Cox analysis black race, smoking 10+ packs years, dyslipidemia, current CD4 cell count x101, cumulative viral load and time on NNRTI were independent predictors of CVE. Conclusion: Both traditional and HIV-related factors were associated with incident CVE. Risk scores were inconsistent in classifying patients who had CVE as high risk, indicating that validation studies are required to improve risk assessment of PLHA in Brazil.},
 year = {2021}
}

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TY  - JOUR
T1  - Factors Associated with Incident Cardiovascular Events and Cardiac Risk Assessment in a Cohort of HIV-infected Participants in Rio de Janeiro
AU  - Rodrigo Carvalho Moreira
AU  - Mariana Alencar Miranda
AU  - Jessica Muller
AU  - Sandra Wagner Cardoso
AU  - Ronaldo Ismerio Moreira
AU  - Estevao Nunes
AU  - Rosane Griep
AU  - Maria Jesus Fonseca
AU  - Valdilea Veloso
AU  - Beatriz Grinsztejn
AU  - Dora Chor
AU  - Antonio Guilherme Pacheco
Y1  - 2021/02/09
PY  - 2021
N1  - https://doi.org/10.11648/j.ijidt.20210601.13
DO  - 10.11648/j.ijidt.20210601.13
T2  - International Journal of Infectious Diseases and Therapy
JF  - International Journal of Infectious Diseases and Therapy
JO  - International Journal of Infectious Diseases and Therapy
SP  - 17
EP  - 26
PB  - Science Publishing Group
SN  - 2578-966X
UR  - https://doi.org/10.11648/j.ijidt.20210601.13
AB  - Background: Cardiovascular events (CVEs) have emerged as an important cause of morbimortality in people living with HIV/AIDS (PLHA). We aimed to investigate factors associated with incident CVE and compare the observed incidence with the predicted CVE risk by three different equations. Methods: Among the 649 active participants of the INI-ELSA cohort, we analysed data of 644 individuals free of CVE at baseline examinations. We used Cox regression models to study factors associated with CVE and to assess the equation's performance we compared the observed incidence with the overall 5-year predicted risks. Results: Over a median follow-up of 6.26-years (interquartile range [IQR] 6.01-6.47), there were 18 CVE, four deaths. Overall, 57.92% were male, median age was 43.4 years (35.82-50.73), most were on cART (88.65%). Participants who had CVE were older, had poorer renal function, higher proportion of dyslipidemia and higher levels of systolic blood pressure and triglycerides. The observed CVE rate was 2.90% (1.60-4.90%) whereas their overall cardiovascular disease (CVD) risk differed depending on which score was used: 0.91 (0.42-20), 1.16 (0.38-2.78) and 1.68 (0.60-3.87), according to Framingham, ASCVD and DAD, respectively. In the multivariable Cox analysis black race, smoking 10+ packs years, dyslipidemia, current CD4 cell count x101, cumulative viral load and time on NNRTI were independent predictors of CVE. Conclusion: Both traditional and HIV-related factors were associated with incident CVE. Risk scores were inconsistent in classifying patients who had CVE as high risk, indicating that validation studies are required to improve risk assessment of PLHA in Brazil.
VL  - 6
IS  - 1
ER  -

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