title: Prevalence of cardiovascular diseases in HIV-infected outpatients: results from a prospective, multicenter cohort study.
abstract: BACKGROUND
  Recent studies suggest a rising rate of cardiovascular disease (CVD) in HIV-infected subjects. Although most countries have an aging HIV-infected population, there remains a lack of knowledge about associated cardiovascular diseases.
  
  
  METHODS
  This ongoing prospective multicentre observational cohort study aims to elucidate CVD prevalence in HIV-infected outpatients by standardized non-invasive cardiovascular screening. Cardiovascular and coronary risk was calculated using Framingham risk scores.
  
  
  RESULTS
  803 HIV-infected subjects (mean age 44.2 years, female 16.6 %) were included. The prevalence of CVD in HIV-infected subjects was 10.1 % (95 % CI 8.0-12.2 %). Aging HIV-infected patients (≥45 years, N = 348) exhibited significantly increased rates of CVD, including an elevated frequency of coronary artery disease (7.5 vs. 1.8 %, p < 0.001), myocardial infarction (6.0 vs. 1.8 %, p = 0.002) and peripheral arterial diseases (4.6 vs. 1.5 %, p < 0.017). Furthermore, aging patients exhibited a higher rate of chronic heart failure (5.2 vs. 1.5 %, p < 0.001), predominantly of ischemic etiology. In multivariate analyses, age (OR 2.05 per decade, 95 % CI 1.64-2.56), smoking (OR 5.96 per decade, 95 % CI 2.31-15.38) and advanced symptomatic HIV infection (OR 2.60 per decade, 95 % CI 1.31-5.15), were significantly associated with the prevalence of CVD. Based on the 10-year cardiovascular risk estimation, a disproportionate increase in cardiac events has to be expected in aging HIV-infected subjects in the next decades (≥45 years/<45 years 16.4 vs. 4.2 %, p < 0.001).
  
  
  CONCLUSIONS
  CVD in aging HIV-infected population is an increasing medical challenge. In the era of antiretroviral therapy, prevention and diagnostic strategies are essential to reduce the prevalence of CVD in HIV-infected patients.
authors.affiliation: Department of Dermatology and Venerology, University Hospital Essen, University of Duisburg-Essen, Medical School, Hufelandstr. 55, 45122, Essen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Esser
authors.forename: Götz
authors.initials: G
authors.lastname: Gelbrich
authors.forename: Norbert
authors.initials: N
authors.lastname: Brockmeyer
authors.forename: Alexander
authors.initials: A
authors.lastname: Goehler
authors.forename: Dirk
authors.initials: D
authors.lastname: Schadendorf
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Till
authors.initials: T
authors.lastname: Neumann
authors.forename: Nico
authors.initials: N
authors.lastname: Reinsch
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D016009:Chi-Square Distribution; D005260:Female; D005858:Germany / Q000453:epidemiology; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010045:Outpatients / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors