Methods: Retrospective chart review was conducted in 2018 to evaluate HAART therapy, CD4, viral suppression, HCV coinfection or treatment history, comorbid conditions, BMI, renal function and current medications. Patients were evaluated for CV events (defined as myocardial infarction, cerebrovascular events, transient ischemic attacks and peripheral artery disease).
Results: At follow up, 60 (49%) patients with a mean age of 65 years remained in care at CORE. Mean CD4 count was 529 cells/mm3 and 82% had undetectable HIVRNA. 22 patients had died (18%), 10(8%) had transferred care and 29(24%) lost to follow up. The mean age at death was 61 years. The causes of death were CV (18.2%), cancer (36.4%), infection (18.5%) and other (27.2%; organ failure/overdose/unknown). On Univariate analysis, Framingham cardiac risk (FCR) of >10% at baseline (2005/2006) was associated with increased CV events (p=0.05). FCR >20% was associated with increased death (p=0.01). Smoking at baseline and follow up were associated with increased CV events (p=0.05 and p=0.035, respectively). Evaluation of medication regimen showed history of protease inhibitor use or current use of integrase inhibitor was associated with increased CV events (p=0.01 and p=0.011 respectively). History of depression was associated with increased CV events (p=0.035). Aspirin use at initial assessment was associated with decreased death (p<0.000).
Conclusion: This retrospective study shows that FCR, history of depression and smoking are associated with adverse outcomes in HIV patients. It suggests that the FCR is useful for risk stratification of cardiovascular disease in HIV patients. It is extremely important to identify and manage cardiac risk factors in older HIV patients to reduce cardiovascular morbidity and mortality.
O. Adeyemi, None
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