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Severity of cardiovascular disease outcomes among patients with HIV is related to markers of inflammation and coagulation
- Source :
- Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Journal of the American Heart Association, 3(3). Wiley-Blackwell, Nordell, A D, McKenna, M, Borges, Á H, Duprez, D, Neuhaus, J, Neaton, J D & INSIGHT SMART, ESPRIT Study Groups 2014, ' Severity of cardiovascular disease outcomes among patients with HIV is related to markers of inflammation and coagulation ', Journal of the American Heart Association, vol. 3, no. 3, pp. e000844 . https://doi.org/10.1161/JAHA.114.000844, Nordell, A D, McKenna, M, Borges, Á H, Duprez, D, Neuhaus, J, Neaton, J D, INSIGHT SMART, ESPRIT Study Groups & Andersen, Å B 2014, ' Severity of cardiovascular disease outcomes among patients with HIV is related to markers of inflammation and coagulation ', Journal of the American Heart Association, vol. 3, no. 3, e000844 . https://doi.org/10.1161/JAHA.114.000844, Dipòsit Digital de la UB, Universidad de Barcelona, Nordell, A D, McKenna, M, Borges, Á H, Duprez, D, Neuhaus, J, Neaton, J D & INSIGHT SMART, ESPRIT Study Groups 2014, ' Severity of cardiovascular disease outcomes among patients with HIV is related to markers of inflammation and coagulation ', American Heart Association. Journal. Cardiovascular and Cerebrovascular Disease, vol. 3, e000844, pp. 1-10 . https://doi.org/10.1161/JAHA.114.000844, Recercat. Dipósit de la Recerca de Catalunya, instname
- Publication Year :
- 2014
-
Abstract
- Background In the general population, raised levels of inflammatory markers are stronger predictors of fatal than nonfatal cardiovascular disease ( CVD ) events. People with HIV have elevated levels of interleukin‐6 ( IL ‐6), high‐sensitivity C‐reactive protein (hs CRP ), and D‐dimer; HIV ‐induced activation of inflammatory and coagulation pathways may be responsible for their greater risk of CVD . Whether the enhanced inflammation and coagulation associated with HIV is associated with more fatal CVD events has not been investigated. Methods and Results Biomarkers were measured at baseline for 9764 patients with HIV and no history of CVD . Of these patients, we focus on the 288 that experienced either a fatal (n=74) or nonfatal (n=214) CVD event over a median of 5 years. Odds ratios ( OR s) (fatal versus nonfatal CVD ) (95% confidence intervals [ CIs ]) associated with a doubling of IL ‐6, D‐dimer, hs CRP , and a 1‐unit increase in an IL ‐6 and D‐dimer score, measured a median of 2.6 years before the event, were 1.39 (1.07 to 1.79), 1.40 (1.10 to 1.78), 1.09 (0.93 to 1.28), and 1.51 (1.15 to 1.97), respectively. Of the 214 patients with nonfatal CVD , 23 died during follow‐up. Hazard ratios (95% CI ) for all‐cause mortality were 1.72 (1.28 to 2.31), 1.73 (1.27 to 2.36), 1.44 (1.15 to 1.80), and 1.88 (1.39 to 2.55), respectively, for IL ‐6, D‐dimer, hs CRP , and the IL ‐6 and D‐dimer score. Conclusions Higher IL ‐6 and D‐dimer levels reflecting enhanced inflammation and coagulation associated with HIV are associated with a greater risk of fatal CVD and a greater risk of death after a nonfatal CVD event. Clinical Trial Registration URL: http://www.clinicaltrial.gov Unique identifier: SMART: NCT00027352, ESPRIT: NCT00004978, SILCAAT: NCT00013611.
- Subjects :
- Male
Epidemiology
HIV Infections
Disease
cardiovascular disease
inflammation
Adult
Biological Markers
C-Reactive Protein
Cardiovascular Diseases
Female
Fibrin Fibrinogen Degradation Products
Humans
Inflammation
Interleukin-6
Middle Aged
Odds Ratio
Blood Coagulation
Medicine
Original Research
education.field_of_study
biology
Biochemical markers
Hazard ratio
Blood coagulation
Inflamació
3. Good health
Cardiovascular diseases
Marcadors bioquímics
medicine.symptom
Cardiology and Cardiovascular Medicine
HIV infections
medicine.medical_specialty
Population
Internal medicine
cardiovascular diseases
education
Interleukin 6
Coagulació sanguínia
Malalties cardiovasculars
business.industry
C-reactive protein
Odds ratio
Confidence interval
Surgery
biology.protein
Infeccions per VIH
business
Biomarkers
Subjects
Details
- ISSN :
- 20479980
- Volume :
- 3
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of the American Heart Association
- Accession number :
- edsair.doi.dedup.....58c361562b1f3ae90633255ad06ec8a1