Statins and Aspirin in HIV-infected People: Gap between Guidelines and Clinical Practice. The Results of the HIV-HY Study
Abstract
Publication Date:
2015
Short description:
Statins and Aspirin in HIV-infected People: Gap between Guidelines and Clinical
Practice. The Results of the HIV-HY Study / De Socio, Gv; Calza, L; Ricci, E; Maggi, P; Parruti, G; Celesia, Bm; Orofino, G; Martinelli, C; Madeddu, Giordano; Penco, G; Franzetti, M; Carenzi, L; Taramasso, L; Quirino, T; Bonfanti, P; for Cisai Study, Group. - (2015). (Intervento presentato al convegno 15th European AIDS Conference tenutosi a Barcellona nel 21-24 October 2015).
abstract:
Objectives: International guidelines mandate interventions to prevent cardiovascular diseases (CVD) in HIV-infected patients as
in general population, but few data are available from clinical practice in HIV-positive people.
Methods: Multicenter, nationwide, prospective cohort study, sampling 991consecutive HIV-infected patients. In a 4-year followup,
we investigated CVD prevention care practices involving the use of acetylsalicylic-acid (ASA) and statins. Statin prescription
was evaluated according to two guidelines: The Third-Report of The National-Cholesterol-Education-Program (ATPIII) and The
American College of Cardiology/American Heart Association (ACC/AHA) Recommendations.
Results: Patients were mostly males (70.8%) with mean age at enrolment of 46.4 years (interquartile-range 23-77, standarddeviation
9.5). The median time of follow-up was 40 months (interquartile-range 35-47), patient-years 3235. At the end of
follow-up, 151 (15.2%) patients were on statin treatment. Particularly, statins were taken by 151 out of 351 (43.0%) patients
who should be on statin therapy according to the ATPIII guidelines, and by 151 out of 395 (38.9%) subjects according to the
ACC/AHA recommendations. Overall, 62.2% of patients on statins achieved the ATPIII recommended LDL-C level. At univariate
analysis traditional risk factors such as age, hypertension, smoking, previous CVD event, high CVD-risk and lower eGFR were
strongly associated with statin prescription, while there was an inverse association with chronic hepatitis. At the last follow-up
visit, 97 out of 991 patients (9.8%) were treated with ASA, and the ratio between subjects on ASA and those who needed ASA
for secondary CVD prevention was 50/74 (67.6%). The main factors associated with ASA prescription was statin use and high
CVD-risk.
Conclusion: The prescription of statins and aspirin in HIV-people remains widely sub-optimal, especially for statins, since only
about 40% and 68% of patients requiring statin and ASA use, respectively, are properly treated. Therefore, improving
preventative CVD care in HIV-positive people is an important step towards diminishing the CVD-risk in this population.
in general population, but few data are available from clinical practice in HIV-positive people.
Methods: Multicenter, nationwide, prospective cohort study, sampling 991consecutive HIV-infected patients. In a 4-year followup,
we investigated CVD prevention care practices involving the use of acetylsalicylic-acid (ASA) and statins. Statin prescription
was evaluated according to two guidelines: The Third-Report of The National-Cholesterol-Education-Program (ATPIII) and The
American College of Cardiology/American Heart Association (ACC/AHA) Recommendations.
Results: Patients were mostly males (70.8%) with mean age at enrolment of 46.4 years (interquartile-range 23-77, standarddeviation
9.5). The median time of follow-up was 40 months (interquartile-range 35-47), patient-years 3235. At the end of
follow-up, 151 (15.2%) patients were on statin treatment. Particularly, statins were taken by 151 out of 351 (43.0%) patients
who should be on statin therapy according to the ATPIII guidelines, and by 151 out of 395 (38.9%) subjects according to the
ACC/AHA recommendations. Overall, 62.2% of patients on statins achieved the ATPIII recommended LDL-C level. At univariate
analysis traditional risk factors such as age, hypertension, smoking, previous CVD event, high CVD-risk and lower eGFR were
strongly associated with statin prescription, while there was an inverse association with chronic hepatitis. At the last follow-up
visit, 97 out of 991 patients (9.8%) were treated with ASA, and the ratio between subjects on ASA and those who needed ASA
for secondary CVD prevention was 50/74 (67.6%). The main factors associated with ASA prescription was statin use and high
CVD-risk.
Conclusion: The prescription of statins and aspirin in HIV-people remains widely sub-optimal, especially for statins, since only
about 40% and 68% of patients requiring statin and ASA use, respectively, are properly treated. Therefore, improving
preventative CVD care in HIV-positive people is an important step towards diminishing the CVD-risk in this population.
Iris type:
4.2 Abstract in Atti di convegno
List of contributors:
De Socio, Gv; Calza, L; Ricci, E; Maggi, P; Parruti, G; Celesia, Bm; Orofino, G; Martinelli, C; Madeddu, Giordano; Penco, G; Franzetti, M; Carenzi, L; Taramasso, L; Quirino, T; Bonfanti, P; for Cisai Study, Group
Book title:
ABSTRACT CD