Frecuencia del síndrome metabólico y estratificación del riesgo cardiovascular en pacientes con VIH mediante tres sistemas de puntuación
Frequency of metabolic syndrome and stratification of cardiovascular risk in patients with HIV by using three scoring systems
Barra lateral del artículo
PDF
FLIP
XML
XML (English)
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
Contenido principal del artículo
Resumen
Introducción: La presencia del síndrome metabólico y el riesgo cardiovascular en pacientes VIH positivos ha sido desestimado en pacientes con infección por VIH. Objetivos: Evaluar la frecuencia del síndrome metabólico y comparar la estratificación del riesgo cardiovascular según las ecuaciones de Framingham, PROCAM y SCORE en pacientes con VIH. Metodología: estudio transversal de 760 adultos infectados por el VIH en el periodo enero de 2016-diciembre de 2018. Se evaluó la presencia de síndrome metabólico a través de los criterios del ATP-III y se examinó la puntuación de riesgo cardiovascular. Resultados: Las comorbilidades más frecuentes fueron el tabaquismo, la hipercolesterolemia y la hipertensión arterial. Se realizó la prueba T de Student, y a partir de ella se lograron apreciar diferencias en categorización de riesgo bajo a moderado. El número de pacientes varones infectados por el VIH identificados como de riesgo cardiovascular moderado según la ecuación de riesgo de Framingham fue mayor del doble en comparación con los sistemas PROCAM y SCORE. Conclusiones: El estudio mostró una alta prevalencia de pacientes con bajo riesgo cardiovascular. Es pertinente considerar los factores de riesgo cardiovascular en pacientes con VIH, ya que estos se encuentran frecuentemente asociados con desenlaces adversos de este tipo.
Palabras clave:
Descargas
Detalles del artículo
Referencias (VER)
Grinspoon S, Carr A. Cardiovascular risk and body-fat abnormalities in HIV-infected adults. N Engl J Med 2005;352:48-62. https://doi.org/10.1056/NEJMra041811 DOI: https://doi.org/10.1056/NEJMra041811
Volberding PA, Murphy RL, Barbaro G, Barbarini G, Bruno R, Cirelli A, et al. The Pavia consensus statement. AIDS 2003;17(Suppl 1):S170-9. https://doi.org/10.1097/00002030-200304001-00021 DOI: https://doi.org/10.1097/00002030-200304001-00021
Dube MP, Stein JH, Aberg JA, Fichtenbaum CJ, Gerber JG, Tashimaet KT, et al. Guidelines for the evaluation and management of dyslipidemia in human immunodeficiency virus (HIV)-infected adults receiving anti- retroviral therapy: recommendations of the HIV Medical Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials Group. Clin Infect Dis. 2003;37:613-27. https://doi.org/10.1086/378131 DOI: https://doi.org/10.1086/378131
National Cholesterol Education Program. Third report of the National Cholesterol Education Program on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486-97. https://doi.org/10.1001/jama.285.19.2486 DOI: https://doi.org/10.1001/jama.285.19.2486
Anderson KV, Wilson PWF, Odell PM, Kannel WB. An updated coronary risk profile. A statement for health professionals. Circulation. 1991;83:356-62. https://doi.org/10.1161/01.CIR.83.1.356 DOI: https://doi.org/10.1161/01.CIR.83.1.356
Haq IU, Jackson PR, Yeo WW, Ramsay LE. Sheffield risk and treatment table for cholesterol lowering for primary prevention of coronary heart disease. Lancet. 1995;346:1467-71. https://doi.org/10.1016/S0140-6736(95)92477-9 DOI: https://doi.org/10.1016/S0140-6736(95)92477-9
Ramsay LE, Haq IU, Jackson PR, Yeo WW, Pickin DM, Payne JN. Targeting lipid-lowering drug therapy for primary prevention of coronary disease: an update Sheffield table. Lancet. 1996;348:387-8. https://doi.org/10.1136/bmj.321.7267.983 DOI: https://doi.org/10.1016/S0140-6736(96)05516-X
Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837-1847. https://doi.org/10.1161/01.CIR.97.18.1837 DOI: https://doi.org/10.1161/01.CIR.97.18.1837
Menotti A, Puddu PE, Lanti M. Comparison of the Framingham risk function-based coronary chart with risk function from an Italian population study. Eur Heart J 2000;21:365-370. https://doi.org/10.1053/euhj.1999.1864 DOI: https://doi.org/10.1053/euhj.1999.1864
Menotti A, Lanti M, Puddu PE, Kromhout D. Coronary heart disease incidence in northern and southern European populations: a reanalysis of the seven countries study for a European coronary risk chart. Heart. 2000;84:238-44. https://doi.org/10.1136/heart.84.3.238 DOI: https://doi.org/10.1136/heart.84.3.238
Thomsen TF, McGee D, Davidsen M, Jørgensen T. A cross-validation of risk-scores for coronary heart disease mortality based on data from the Glostrup Population Studies and Framingham Heart Study. Int J Epidemiol. 2002;31:817-22. https://doi.org/10.1093/ije/31.4.817 DOI: https://doi.org/10.1093/ije/31.4.817
Empana JP, Ducimetiere P, Arveiler D, Ferrières J, Evans A, Ruidavets JB, et al. Are the Framingham and PROCAM coronary heart disease functions applicable to different European populations? The PRIME Study. Eur Heart J 2003;24:1903-11. https://doi.org/10.1016/j.ehj.2003.09.002 DOI: https://doi.org/10.1016/j.ehj.2003.09.002
Friis-Moller N, Weber R, Reiss P, Thiébaut R, Kirk O, d'Arminio Monforte A, et al., for the DAD study group. Cardiovascular disease risk factors in HIV patients: association with antirretroviral therapy. Results from the DAD study. AIDS. 2003;17:1179-93. https://doi.org/10.1097/00002030-200305230-00010 DOI: https://doi.org/10.1097/00002030-200305230-00010
Savès M, Chêne G, Ducimetière P, Leport C, Le Moal G, Amouyel P, et al., for the French WHO MONICA Project and the APROCO (ANRS EP11) Study Group. Risk factors for coronary heart disease in patients treated for human immunodeficiency virus infection compared with the general population. Clin Infect Dis. 2003;37:292-8. https://doi.org/10.1086/375844 DOI: https://doi.org/10.1086/375844
Smith CJ, Levy I, Sabin CA, Kaya E, Johnson MA, Lipman MC. Cardiovascular disease risk factors and antirretroviral therapy in an HIV-positive UK population. HIV Med. 2004 Mar;5(2):88-92. https://doi.org/10.1111/j.1468-1293.2004.00191.x DOI: https://doi.org/10.1111/j.1468-1293.2004.00191.x
Dolan SE, Hadigan C, Killilea KM, Sullivan MP, Hemphill L, Lees RS, et al. Increased cardiovascular disease risk indices in HIV-infected women. J Acquir Immune Defic Syndr. 2005;39:44-54. https://doi.org/10.1097/01.qai.0000159323.59250.83 DOI: https://doi.org/10.1097/01.qai.0000159323.59250.83
Hadigan C, Meigs JB, Wilson PWF, D'Agostino RB, Davis B, Basgoz N, et al. Prediction of coronary heart disease risk in HIV-infected patients with fat redistribution. Clin Infect Dis. 2003;36:909-16. https://doi.org/10.1086/368185 DOI: https://doi.org/10.1086/368185
Bergersen BM, Sandvik L, Bruun JN, Tonstad S. Elevated Framingham risk score in HIV-positive patients on highly active antirretroviral therapy: results from a Norwegian study of 721 subjects. Eur J Clin Microbiol Infect Dis. 2004;23:625-30. https://doi.org/10.1007/s10096-004-1177-6 DOI: https://doi.org/10.1007/s10096-004-1177-6
Law MG, Friis-Moller N, El-Sadr WM, Weber R, Reiss P, D'Arminio Monforte A, et al., D:A:D Study Group. The use of the Framingham equation to predict myocardial infarctions in HIV-infected patients: comparison with observed events in the D:A:D Study. HIV Med. 2006;7:218-30. https://doi.org/10.1111/j.1468-1293.2006.00362.x DOI: https://doi.org/10.1111/j.1468-1293.2006.00362.x
Assman G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10-year follow-up of the prospective cardiovascular Munster (PROCAM) study. Circulation. 2002;105:310-5. https://doi.org/10.1161/hc0302.102575 DOI: https://doi.org/10.1161/hc0302.102575
De Backer G, Ambrosioni E, Borch-Johnsen K, et al., European Society of Cardiology. American Heart Association. American College of Cardiology. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of eight societies and by invited experts). Atherosclerosis. 2004;173:381-91. https://doi.org/10.1097/01.hjr.0000087913.96265.e2
Jericó C, Knobel H, Montero M, Ordoñez-Llanos J, Guelar A, Gimeno JL, et al. Metabolic syndrome among HIV-infected patients: prevalence, characteristics and related factors. Diabetes Care. 2005;28:132-7. https://doi.org/10.2337/diacare.28.1.132 DOI: https://doi.org/10.2337/diacare.28.1.132
Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-V). Arch Intern Med. 1993;153:154-83. https://doi.org/10.1001/archinte.1993.00410020010002 DOI: https://doi.org/10.1001/archinte.153.2.154
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Summary of the second report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel II). JAMA. 1993;269:3015-23. https://doi.org/10.1001/jama.285.19.2486 DOI: https://doi.org/10.1001/jama.269.23.3015
Pyörälä K. Assessment of coronary heart disease risk in populations with different levels risk. Eur Heart J. 2000;21:348-50. https://doi.org/10.1016/S0195-668X(03)00114-3 DOI: https://doi.org/10.1053/euhj.1999.1927
Citado por
