Incidence and Predictors of Myocardial Infarction Among HIV-Infected Patients

HIV 感染者心肌梗塞的发病率和预测因素

• 批准号: 8039198
• 负责人: Virginia Athena Triant
• 金额: $ 13.8万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8039198
• 关键词: Acute myocardial infarction; Age; Cardiac; Cardiovascular Diseases; Caring; Characteristics; Clinical; Clinical Data; Clinical Trials; Cohort Studies; Coronary heart disease; Cross-Sectional Studies; Data; Data Sources; Development; Diabetes Mellitus; Dyslipidemias; Environment; Gender; Goals; HIV; HIV Infections; Healthcare Systems; Hypertension; Incidence; Life; Mentors; Modeling; Modification; Myocardial Infarction; Observational Study; Outcome; Patients; Public Health Applications Research; Race; Research Design; Research Personnel; Resources; Risk; Risk Factors; Smoking; Validation; Woman; antiretroviral therapy; base; cardiovascular risk factor; career development; cohort; data registry; improved; insight; longitudinal analysis; novel; prospective; tool; treatment strategy

DESCRIPTION (provided by candidate): In an era when HIV-infected patients are living longer on antiretroviral therapy, understanding the complications of long-standing HIV infection and its treatment is critical to the care of this group. Recent studies indicate increased rates of cardiovascular risk factors among HIV patients, and several studies have evaluated coronary heart disease rates among HIV patients. No study to date, however, has examined the issue prospectively comparing HIV patients to demographically matched non-HIV controls. The primary aim of the proposed study is to examine the incidence and predictors of myocardial infarction among an HIV cohort compared to a non-HIV cohort using a prospective observational study design. Specific aims include: Aim 1: To investigate the baseline characteristics and cardiovascular risk profile of HIV and non-HIV cohorts derived from a large health care system-based data registry. Aim 2: To determine the incidence of acute myocardial infarction over a four-year period in HIV and non-HIV cohorts derived from a large health care system-based data registry in a prospective case cohort study. Aim 3: To analyze the predictors of acute myocardial infarction in a multivariate regression model and to validate a risk prediction tool in HIV and non-HIV cohorts. To achieve these goals, a unique data source will be employed that allows investigators to generate cohorts and track outcomes for large numbers of patients for whom comprehensive demographic and clinical data are reliably captured. The results of this study will have implications for the optimal management of HIV patients with respect to cardiovascular disease. These insights will be especially important for groups in whom cardiac risk is thought to be low in the absence of HIV infection, such as young women. The public health applications of this research will include the development of cardiovascular risk prediction, risk modification, and treatment strategies tailored to HIV patients. Such strategies will likely take on increasing importance in resource-limited settings as antiretroviral therapy becomes more widely available. The intersection of HIV and cardiovascular disease is an emerging and significant field. The strength of the candidate's commitment and background, a team of mentors with a wide range of expertise, and extensive institutional resources will provide a uniquely well-suited environment to promote career development in clinical investigation and improve the well being of HIV patients.

描述（由候选人提供）：在一个艾滋病毒感染的患者在抗逆转录病毒疗法上寿命更长的时代，了解长期存在的HIV感染及其治疗对这一组的护理至关重要。最近的研究表明，艾滋病毒患者的心血管危险因素发生率提高，几项研究评估了艾滋病毒患者的冠心病率。然而，迄今为止，还没有研究该问题，将艾滋病毒患者与人口统计学匹配的非HIV对照进行比较。拟议研究的主要目的是使用前瞻性观察性研究设计与非HIV队列相比，与非HIV队列相比，HIV队列中心肌梗塞的发生率和预测因子。具体目的包括： 目的1：研究艾滋病毒和非HIV队列的基线特征和心血管风险概况，这些艾滋病毒和非HIV队列来自大型医疗保健系统的数据注册中心。 目的2：在一项前瞻性病例队列研究中，在四年的艾滋病毒和非HIV同类中，确定急性心肌梗死的发生率。 目标3：分析多元回归模型中急性心肌梗死的预测因子，并验证HIV和非HIV队列中的风险预测工具。 为了实现这些目标，将采用独特的数据源，允许研究人员为大量全面的人口统计学和临床​​数据可靠地捕获的大量患者产生同类和跟踪结果。这项研究的结果将对艾滋病毒患者在心血管疾病方面的最佳治疗产生影响。这些见解对于认为在没有艾滋病毒感染（例如年轻妇女）的情况下被认为较低的心脏风险的群体尤其重要。这项研究的公共卫生应用将包括开发针对HIV患者量身定制的心血管风险预测，风险修改和治疗策略。随着抗逆转录病毒疗法变得更广泛，此类策略可能会提高在资源有限的环境中的重要性。艾滋病毒和心血管疾病的交集是一个新兴而重要的领域。候选人的承诺和背景的实力，具有广泛专业知识和广泛的机构资源的导师团队将为促进临床调查中的职业发展，并改善HIV患者的健康状况。