Associação dos biomarcadores com aterosclerose e risco para doença coronariana em portadores de HIV

Falcão, Maria da Conceição Brandão de Arruda; Zirpoli, Josefina Cláudia; Albuquerque, Valéria Maria de; Filho, Brivaldo Markman; Araujo, Nelson A.; Falcão, Creso Abreu; Miranda-Filho, Demócrito de Barros; Ximenes, Ricardo A. A.; Albuquerque, Maria de Fátima Militão de; Lacerda, Heloísa Ramos

doi:10.1590/s0066-782x2012005000093

Cited by 17 publications

(7 citation statements)

References 24 publications

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“…Six studies, describing five patient populations, were prospective with a follow-up duration ranging from 48 to 144 weeks. [ 19 , 20 , 23 , 30 , 32 , 33 ] The methods that were used to assess the relation between CRP and CIMT differed, varying from a change in CRP versus CIMT progression in a follow-up period of 48 weeks[ 34 ], to the association of the baseline level of CRP and CIMT progression in a follow-up period of 48 to 96 weeks[ 19 , 20 ] to the association of the increase of CRP at baseline (in units or doubling of the normal value) versus CIMT increase in millimeters per year[ 30 , 59 ].…”

Section: Resultsmentioning

confidence: 99%

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Pro-Inflammatory Markers in Relation to Cardiovascular Disease in HIV Infection. A Systematic Review

et al. 2016

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BackgroundIn the past years many inflammatory markers have been studied in association with clinically manifest cardiovascular disease (CVD) and carotid intima-media thickness (CIMT) in HIV-infected patients, to obtain insights in the increased cardiovascular risk observed in HIV infection. This systematic review provides an oversight of the current knowledge.MethodsA search was performed in PubMed, Embase and Cochrane in July 2014, identifying all articles from 1996 onwards addressing the relation between inflammatory markers and CVD or CIMT in HIV-positive adults. Two authors, using predefined criteria, independently conducted the selection of articles, critical appraisal and extraction of the data. Analysis was focused on the immune markers that were most frequently assessed. The review protocol was registered in the PROSPERO database at 11 July 2014 (registration number CRD42014010516). This review was performed according to the PRISMA guideline.FindingsForty articles were selected; eight addressing cardiovascular disease (CVD) and thirty-two addressing CIMT. C-reactive protein (CRP), interleukin-6 (IL-6) and d-dimer were assessed most frequently in relation to the occurrence of CVD; in four out of eight studies. All three markers were positively related to CVD in three out of four studies. Studies addressing CIMT were too heterogeneous with respect to patient populations, inflammatory markers, CIMT measurement protocols and statistical methods to allow for a formal meta-analysis to obtain summary statistics. CRP, IL-6 and soluble vascular cell adhesion molecule (sVCAM-1) were the most studied markers in relation to CIMT. None of the inflammatory markers showed an association with CIMT.InterpretationThis review showed a relation between some inflammatory markers and CVD, however, no consistent relation is observed for CIMT. Statistical approaches that yields effect estimates and standardized CIMT protocols should be chosen. Further research should focus on prospective studies and a selected set of inflammatory markers.

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Section: Resultsmentioning

confidence: 99%

“…IL-6 was assessed in 13 studies [ 10 , 15 , 18 – 20 , 33 , 34 , 39 – 43 , 47 , 50 ] ( Fig 4b ), six studies only mentioned that the association was non-significant. [ 18 – 20 , 33 , 39 , 43 ]…”

Section: Resultsmentioning

confidence: 99%

Pro-Inflammatory Markers in Relation to Cardiovascular Disease in HIV Infection. A Systematic Review

et al. 2016

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“…HIV infection and antiretroviral therapy might accelerate atherogenesis, as do traditional risk factors. First, a chronic systemic inflammatory state, endothelial dysfunction, and prothrombotic state caused by the virus itself contribute to the pathogenesis of coronary disease [4, 18–22]; therefore, viral suppression should be maintained to reduce vascular damage [20, 37, 38]. The higher prevalence of coronary atherosclerosis in young asymptomatic men with long-standing HIV infection in comparison with non-HIV-1-infected subjects supports the role of the virus [4, 18, 19, 32].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

Echeverría

Domingo

Llibre

et al. 2014

BioMed Research International

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Background. There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF) in HIV-infected patients. Methods. We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results. We identified 81 patients with a history of a coronary event (prevalence 2.15%); 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus). Other CVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol (P = 0.025) and LDL-cholesterol (P = 0.004) was observed. However, the percentage of patients who maintained LDL-cholesterol > 100 mg/dL remained stable (from 46% to 41%, P = 0.103). Patients using protease inhibitors associated with a favorable lipid profile increased over time (P = 0.028). Conclusions. The prevalence of coronary events in our cohort is low. CVRF prevalence is high and their management is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients.

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“…Even though there are already a considerable number of studies in developed countries that show the association between HIV infection itself and cIMT and several other factors associated with increased cIMT among HIV-infected patients, very few data have been published to date in low and middle income countries, including the Brazilian population [ 23 , 24 ], where patients present several contextual differences as compared to high income countries population such as socioeconomic and psychosocial aspects, which affect access to the health system and availability of medication as well as the prevalence of atherosclerosis traditional risk factors. In this study we describe variables associated with cIMT in HIV-infected patients in a large sample of the Instituto de Pesquisa Clínica Evandro Chagas (IPEC) cohort in Rio de Janeiro, Brazil.…”

Section: Introductionmentioning

confidence: 99%

Traditional Risk Factors Are More Relevant than HIV-Specific Ones for Carotid Intima-Media Thickness (cIMT) in a Brazilian Cohort of HIV-Infected Patients

et al. 2015

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BackgroundCombination antiretroviral therapy (cART) had a dramatic impact on the mortality profile in human immunodeficiency virus (HIV) infected individuals and increased their life-expectancy. Conditions associated with the aging process have been diagnosed more frequently among HIV-infected patients, particularly, cardiovascular diseases.MethodsPatients followed in the Instituto de Pesquisa Clínica Evandro Chagas (IPEC) prospective cohort in Rio de Janeiro were submitted to the general procedures from the Brazilian Longitudinal Study of Adult Health, comprising several anthropometric, laboratory and imaging data. Carotid intima-media thickness (cIMT) was measured by ultrasonography, following the Mannheim protocol. Linear regression and proportional odds models were used to compare groups and covariables in respect to cIMT. The best model was chosen with the adaptive lasso procedure.ResultsA valid cIMT exam was available for 591 patients. Median cIMT was significantly larger for men than women (0.56mm vs. 0.53mm; p = 0.002; overall = 0.54mm). In univariable linear regression analysis, both traditional risk factors for cardiovascular diseases (CVD) and HIV-specific characteristics were significantly associated with cIMT values, but the best multivariable model chosen included only traditional characteristics. Hypertension presented the strongest association with higher cIMT terciles (OR = 2.51; 95%CI = 1.69–3.73), followed by current smoking (OR = 1,82; 95%CI = 1.19–2.79), family history of acute myocardial infarction or stroke (OR = 1.60; 95%CI = 1.10–2.32) and age (OR per year = 1.12; 95%CI = 1.10–1.14).ConclusionsOur results show that traditional cardiovascular disease (CVD) risk factors are the major players in determining increased cIMT among HIV infected patients in Brazil. This finding reinforces the need for thorough assessment of those risk factors in these patients to guarantee the incidence of CVD events remain under control.

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Associação dos biomarcadores com aterosclerose e risco para doença coronariana em portadores de HIV

Abstract: There was no association between inflammatory biomarkers, adhesion molecules and presence of carotid atherosclerosis. However, a higher chance of subclinical atherosclerosis was observed in men, those older than 40 years, with intermediate / high Framingham score or metabolic syndrome.

Cited by 17 publications

References 24 publications

Pro-Inflammatory Markers in Relation to Cardiovascular Disease in HIV Infection. A Systematic Review

Pro-Inflammatory Markers in Relation to Cardiovascular Disease in HIV Infection. A Systematic Review

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

Traditional Risk Factors Are More Relevant than HIV-Specific Ones for Carotid Intima-Media Thickness (cIMT) in a Brazilian Cohort of HIV-Infected Patients

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