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Title: Cardiovascular disease-related mortality and factors associated with cardiovascular events in the TREAT Asia HIV Observational Database (TAHOD)
Authors: R. Bijker
A. Jiamsakul
E. Uy
N. Kumarasamy
R. Ditango
R. Chaiwarith
W. W. Wong
A. Avihingsanon
L. P. Sun
E. Yunihastuti
S. Pujari
C. D. Do
T. P. Merati
P. Kantipong
K. V. Nguyen
A. Kamarulzaman
F. Zhang
M. P. Lee
J. Y. Choi
J. Tanuma
O. T. Ng
B. L.H. Sim
J. Ross
S. Kiertiburanakul
P. S. Ly
R. Ditangco
D. D. Cuong
A. H. Sohn
M. G. Law
Hospital Sungai Buloh
Beijing Ditan Hospital Capital Medical University
VHS Medical Centre India
Bach Mai Hospital
Universitas Udayana
University of Indonesia, RSUPN Dr. Cipto Mangunkusumo
Kirby Institute
National Center for Global Health and Medicine
The HIV Netherlands Australia Thailand Research Collaboration
Yonsei University College of Medicine
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Queen Elizabeth Hospital Hong Kong
University of Malaya Medical Centre
Veterans General Hospital-Taipei
Tan Tock Seng Hospital
Chiang Mai University
University of Health Sciences
National Hospital for Tropical Diseases
Foundation for AIDS Research
Institute of Infectious Diseases
Chiangrai Prachanukroh Hospital
Keywords: Medicine
Issue Date: 1-Mar-2019
Citation: HIV Medicine. Vol.20, No.3 (2019), 183-191
Abstract: © 2019 British HIV Association Objectives: With aging of the HIV-positive population, cardiovascular disease (CVD) increasingly contributes to morbidity and mortality. We investigated CVD-related and other causes of death (CODs) and factors associated with CVD in a multi-country Asian HIV-positive cohort. Methods: Patient data from 2003–2017 were obtained from the Therapeutics, Research, Education and AIDS Training in Asia (TREAT Asia) HIV Observational Database (TAHOD). We included patients on antiretroviral therapy (ART) with > 1 day of follow-up. Cumulative incidences were plotted for CVD-related, AIDS-related, non-AIDS-related, and unknown CODs, and any CVD (i.e. fatal and nonfatal). Competing risk regression was used to assess risk factors of any CVD. Results: Of 8069 patients with a median follow-up of 7.3 years [interquartile range (IQR) 4.4–10.7 years], 378 patients died [incidence rate (IR) 6.2 per 1000 person-years (PY)], and this total included 22 CVD-related deaths (IR 0.36 per 1000 PY). Factors significantly associated with any CVD event (IR 2.2 per 1000 PY) were older age [sub-hazard ratio (sHR) 2.21; 95% confidence interval (CI) 1.36–3.58 for age 41–50 years; sHR 5.52; 95% CI 3.43–8.91 for ≥ 51 years, compared with < 40 years], high blood pressure (sHR 1.62; 95% CI 1.04–2.52), high total cholesterol (sHR 1.89; 95% CI 1.27–2.82), high triglycerides (sHR 1.55; 95% CI 1.02–2.37) and high body mass index (BMI) (sHR 1.66; 95% CI 1.12–2.46). CVD crude IRs were lower in the later ART initiation period and in lower middle- and upper middle-income countries. Conclusions: The development of fatal and nonfatal CVD events in our cohort was associated with older age, and treatable risk factors such as high blood pressure, triglycerides, total cholesterol and BMI. Lower CVD event rates in middle-income countries may indicate under-diagnosis of CVD in Asian-Pacific resource-limited settings.
ISSN: 14681293
Appears in Collections:Scopus 2019

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