Factors Affecting Risk of Cardiovascular Disease (CVD) Events in a Global CVD Prevention Cohort of People With HIV

作者：Steven Grinspoon, Maya Watanabe, Heather J. Ribaudo, Gerald S. Bloomfield, Carl J. Fichtenbaum, Triin Umbleja, Sarah M Chu, Kathleen V. Fitch, Marissa R Diggs, Sophia Zhao, Sara E. Looby, Judith S. Currier, Judith A. Aberg, Carlos Malvestutto, Kristine M. Erlandson, Estebán Martínez, Olabimpe Asupoto, Samir K. Gupta, Juan Carlos López-Bernaldo de Quirós, Daniel E. Nixon, Roger Bedimo, Michael T. Lu, Pamela S. Douglas, Markella V. Zanni · 发表于：Clinical Infectious Diseases · 年份：2025 · DOI：10.1093/cid/ciaf210 · 被引用次数：8 · 研究领域：HIV-related health complications and treatments、Lipoproteins and Cardiovascular Health、Diabetes, Cardiovascular Risks, and Lipoproteins

BACKGROUND: Persons with HIV face increased risks of major adverse cardiovascular events (MACE), partially mitigated by statin therapy. METHODS: We characterized factors associated with MACE and MACE subcomponents among PWH enrolled in REPRIEVE, globally. Our primary outcome measure was time-to-first primary MACE. Secondary outcome measures included time-to-first (1) hard MACE (cardiovascular disease [CVD] death, myocardial infarction [MI], or stroke), (2) MI, or (3) stroke. For each outcome, Cox proportional hazards models were used to estimate the hazard of baseline risk factors. RESULTS: Among participants (N = 7769), median age was 50 (Q1, Q3: 45, 55) years, and 31% were female. In fully adjusted models, risk of first MACE was higher for older individuals (50-59 and ≥60 vs 40-49 years; HR [95% CI]: 2.06 [1.54-2.76] and 2.53 [1.60-4.01]) and for those with Black/African-American race (vs White race, within HICs; HR: 1.65; 1.19-2.27), family history of premature CVD (HR: 1.53; 1.16-2.03), current cigarette smoking (HR: 2.27; 1.65-3.13), hypertension (HR: 1.77; 1.36-2.30), lower HDL cholesterol (HR: 1.21; 1.10-1.34), HIV-1 RNA ≥lower limit of quantification (LLQ) (HR: 1.40; 1.0-1.97), and a select antiretroviral therapy class combination (HR: 1.53; 1.01-2.31). Individuals from HICs had a higher risk of first MACE versus those from other regions, except South Asia. There was no apparent protective effect of female sex. Modeling for hard MACE, MI, and stroke yielded similar re...