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Atazanavir is not associated with an increased risk of cardio or cerebrovascular disease events

Identifieur interne : 005083 ( Main/Exploration ); précédent : 005082; suivant : 005084

Atazanavir is not associated with an increased risk of cardio or cerebrovascular disease events

Auteurs : Antonella D'Arminio Monforte [Italie] ; Peter Reiss [Pays-Bas] ; Lene Ryom [Danemark] ; Wafaa Ei-Sadr [États-Unis] ; Francois Dabis [France] ; Stephane De Wit [Belgique] ; Signe W. Worm [Danemark] ; Mathew G. Law [Australie] ; Rainer Weber [Suisse] ; Ole Kirk [Danemark] ; Christian Pradier [France] ; Andrew N. Phillips [Royaume-Uni] ; Jens D. Lundgren [Danemark] ; Caroline A. Sabin [Royaume-Uni]

Source :

RBID : Pascal:13-0099148

Descripteurs français

English descriptors

Abstract

Objective: To investigate whether there is any association between exposure to atazanavir (ATV), either when boosted or unboosted by ritonavir, and myocardial infarction (MI) or stroke within the D:A:D: Study. Design: Prospective cohort collaboration. Methods: Poisson regression was used to investigate the association between cumulative exposure to ATV and MI/stroke risk after adjusting for known demographic and clinical confounders, as well as cumulative and recent exposure to specific antiretroviral drugs. Follow-up started on enrolment in the study and ended at the earliest of: a new MI/stroke event, death, 6 months after last clinic visit, or 1 February 2011. Results: The incidence of MI varied from 0.28 [95% confidence interval (CI) 0.26- 0.30)]/100 person-years of follow-up (PYFU) in those with no exposure to ATV to 0.20 (0.12-0.32)/100 PYFU in those with more than 3 years exposure. There was no evidence of an association between cumulative exposure to ATV and MI risk, either in univariate [relative rate/year 0.96 (95% CI 0.88-1.04)] or multivariable [0.95 (0.87-1.05)] analyses. The incidence of stroke was 0.17 (0.16-0.19)/100 PYFU in those with no exposure to ATV and 0.17 (0.10-0.27)/100 PYFU in those with more than 3 years exposure. As with the MI endpoint, there was no evidence of an association with ATV exposure in either univariate [1.02 (0.98-1.05)] or multivariable [0.95 (0.87-1.05)] analyses. Conclusion: These results argue against a class-wide association between exposure to HIV protease inhibitors and the risk of cardio/cerebrovascular events.


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Le document en format XML

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<name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name>
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<name sortKey="Sabin, Caroline A" sort="Sabin, Caroline A" uniqKey="Sabin C" first="Caroline A." last="Sabin">Caroline A. Sabin</name>
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<title xml:lang="en" level="a">Atazanavir is not associated with an increased risk of cardio or cerebrovascular disease events</title>
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<name sortKey="D Arminio Monforte, Antonella" sort="D Arminio Monforte, Antonella" uniqKey="D Arminio Monforte A" first="Antonella" last="D'Arminio Monforte">Antonella D'Arminio Monforte</name>
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<s1>Hospital San Paolo, University of Milan</s1>
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<country>Italie</country>
<wicri:noRegion>Hospital San Paolo, University of Milan</wicri:noRegion>
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<name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name>
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<s1>Academic Medical Center</s1>
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</inist:fA14>
<country>Pays-Bas</country>
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<settlement type="city">Amsterdam</settlement>
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<name sortKey="Ryom, Lene" sort="Ryom, Lene" uniqKey="Ryom L" first="Lene" last="Ryom">Lene Ryom</name>
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<s1>Copenhagen HIV Programme, University of Copenhagen</s1>
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<country>Danemark</country>
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<settlement type="city">Copenhague</settlement>
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<name sortKey="Ei Sadr, Wafaa" sort="Ei Sadr, Wafaa" uniqKey="Ei Sadr W" first="Wafaa" last="Ei-Sadr">Wafaa Ei-Sadr</name>
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<s1>Columbia University/Harlem Hospital</s1>
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<s3>USA</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
<country>États-Unis</country>
<placeName>
<region type="state">État de New York</region>
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<name sortKey="Dabis, Francois" sort="Dabis, Francois" uniqKey="Dabis F" first="Francois" last="Dabis">Francois Dabis</name>
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<s1>INSERM, Centre INSERM U897 'Epidémiologie et Biostatistique</s1>
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<country>France</country>
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<s1>Université Bordeaux Segalen, Institut de Santé Publique Epidémiologie Développement (ISPED)</s1>
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<country>France</country>
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<region type="region">Nouvelle-Aquitaine</region>
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<name sortKey="De Wit, Stephane" sort="De Wit, Stephane" uniqKey="De Wit S" first="Stephane" last="De Wit">Stephane De Wit</name>
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<name sortKey="Worm, Signe W" sort="Worm, Signe W" uniqKey="Worm S" first="Signe W." last="Worm">Signe W. Worm</name>
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<s1>Copenhagen HIV Programme, University of Copenhagen</s1>
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<country>Danemark</country>
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<name sortKey="Law, Mathew G" sort="Law, Mathew G" uniqKey="Law M" first="Mathew G." last="Law">Mathew G. Law</name>
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<country>Australie</country>
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<settlement type="city">Sydney</settlement>
<region type="état">Nouvelle-Galles du Sud</region>
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<name sortKey="Weber, Rainer" sort="Weber, Rainer" uniqKey="Weber R" first="Rainer" last="Weber">Rainer Weber</name>
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<country>Suisse</country>
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<settlement type="city">Zurich</settlement>
<region nuts="3" type="region">Canton de Zurich</region>
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<orgName type="university">Université de Zurich</orgName>
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<name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name>
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<name sortKey="Pradier, Christian" sort="Pradier, Christian" uniqKey="Pradier C" first="Christian" last="Pradier">Christian Pradier</name>
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<s1>CHU Nice Hopital de I'Archet</s1>
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</inist:fA14>
<country>France</country>
<placeName>
<region type="region">Provence-Alpes-Côte d'Azur</region>
<region type="old region">Provence-Alpes-Côte d'Azur</region>
<settlement type="city">Nice</settlement>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Phillips, Andrew N" sort="Phillips, Andrew N" uniqKey="Phillips A" first="Andrew N." last="Phillips">Andrew N. Phillips</name>
<affiliation wicri:level="3">
<inist:fA14 i1="11">
<s1>Research Department of Infection and Population Health, UCL</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>12 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name>
<affiliation wicri:level="3">
<inist:fA14 i1="03">
<s1>Copenhagen HIV Programme, University of Copenhagen</s1>
<s2>Copenhagen</s2>
<s3>DNK</s3>
<sZ>3 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>10 aut.</sZ>
<sZ>13 aut.</sZ>
</inist:fA14>
<country>Danemark</country>
<placeName>
<settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
</affiliation>
</author>
<author>
<name sortKey="Sabin, Caroline A" sort="Sabin, Caroline A" uniqKey="Sabin C" first="Caroline A." last="Sabin">Caroline A. Sabin</name>
<affiliation wicri:level="3">
<inist:fA14 i1="11">
<s1>Research Department of Infection and Population Health, UCL</s1>
<s2>London</s2>
<s3>GBR</s3>
<sZ>12 aut.</sZ>
<sZ>14 aut.</sZ>
</inist:fA14>
<country>Royaume-Uni</country>
<placeName>
<settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
</analytic>
<series>
<title level="j" type="main">AIDS : (London)</title>
<title level="j" type="abbreviated">AIDS : (Lond.)</title>
<idno type="ISSN">0269-9370</idno>
<imprint>
<date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">AIDS : (London)</title>
<title level="j" type="abbreviated">AIDS : (Lond.)</title>
<idno type="ISSN">0269-9370</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>AIDS</term>
<term>Antiretroviral agent</term>
<term>Antiviral</term>
<term>Atazanavir</term>
<term>Cardiovascular disease</term>
<term>Cerebrovascular disease</term>
<term>Human immunodeficiency virus</term>
<term>Myocardial infarction</term>
<term>Risk factor</term>
<term>Stroke</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Pathologie cérébrovasculaire</term>
<term>Pathologie de l'appareil circulatoire</term>
<term>SIDA</term>
<term>Atazanavir</term>
<term>Facteur risque</term>
<term>Infarctus du myocarde</term>
<term>Accident cérébrovasculaire</term>
<term>Virus immunodéficience humaine</term>
<term>Antiviral</term>
<term>Antirétroviral</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Objective: To investigate whether there is any association between exposure to atazanavir (ATV), either when boosted or unboosted by ritonavir, and myocardial infarction (MI) or stroke within the D:A:D: Study. Design: Prospective cohort collaboration. Methods: Poisson regression was used to investigate the association between cumulative exposure to ATV and MI/stroke risk after adjusting for known demographic and clinical confounders, as well as cumulative and recent exposure to specific antiretroviral drugs. Follow-up started on enrolment in the study and ended at the earliest of: a new MI/stroke event, death, 6 months after last clinic visit, or 1 February 2011. Results: The incidence of MI varied from 0.28 [95% confidence interval (CI) 0.26- 0.30)]/100 person-years of follow-up (PYFU) in those with no exposure to ATV to 0.20 (0.12-0.32)/100 PYFU in those with more than 3 years exposure. There was no evidence of an association between cumulative exposure to ATV and MI risk, either in univariate [relative rate/year 0.96 (95% CI 0.88-1.04)] or multivariable [0.95 (0.87-1.05)] analyses. The incidence of stroke was 0.17 (0.16-0.19)/100 PYFU in those with no exposure to ATV and 0.17 (0.10-0.27)/100 PYFU in those with more than 3 years exposure. As with the MI endpoint, there was no evidence of an association with ATV exposure in either univariate [1.02 (0.98-1.05)] or multivariable [0.95 (0.87-1.05)] analyses. Conclusion: These results argue against a class-wide association between exposure to HIV protease inhibitors and the risk of cardio/cerebrovascular events.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Australie</li>
<li>Belgique</li>
<li>Danemark</li>
<li>France</li>
<li>Italie</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>Suisse</li>
<li>États-Unis</li>
</country>
<region>
<li>Angleterre</li>
<li>Aquitaine</li>
<li>Canton de Zurich</li>
<li>Grand Londres</li>
<li>Hollande-Septentrionale</li>
<li>Hovedstaden</li>
<li>Nouvelle-Aquitaine</li>
<li>Nouvelle-Galles du Sud</li>
<li>Provence-Alpes-Côte d'Azur</li>
<li>Région de Bruxelles-Capitale</li>
<li>État de New York</li>
</region>
<settlement>
<li>Amsterdam</li>
<li>Bordeaux</li>
<li>Bruxelles</li>
<li>Copenhague</li>
<li>Londres</li>
<li>Nice</li>
<li>Sydney</li>
<li>Zurich</li>
</settlement>
<orgName>
<li>Université Bordeaux II</li>
<li>Université de Zurich</li>
</orgName>
</list>
<tree>
<country name="Italie">
<noRegion>
<name sortKey="D Arminio Monforte, Antonella" sort="D Arminio Monforte, Antonella" uniqKey="D Arminio Monforte A" first="Antonella" last="D'Arminio Monforte">Antonella D'Arminio Monforte</name>
</noRegion>
</country>
<country name="Pays-Bas">
<region name="Hollande-Septentrionale">
<name sortKey="Reiss, Peter" sort="Reiss, Peter" uniqKey="Reiss P" first="Peter" last="Reiss">Peter Reiss</name>
</region>
</country>
<country name="Danemark">
<region name="Hovedstaden">
<name sortKey="Ryom, Lene" sort="Ryom, Lene" uniqKey="Ryom L" first="Lene" last="Ryom">Lene Ryom</name>
</region>
<name sortKey="Kirk, Ole" sort="Kirk, Ole" uniqKey="Kirk O" first="Ole" last="Kirk">Ole Kirk</name>
<name sortKey="Lundgren, Jens D" sort="Lundgren, Jens D" uniqKey="Lundgren J" first="Jens D." last="Lundgren">Jens D. Lundgren</name>
<name sortKey="Worm, Signe W" sort="Worm, Signe W" uniqKey="Worm S" first="Signe W." last="Worm">Signe W. Worm</name>
</country>
<country name="États-Unis">
<region name="État de New York">
<name sortKey="Ei Sadr, Wafaa" sort="Ei Sadr, Wafaa" uniqKey="Ei Sadr W" first="Wafaa" last="Ei-Sadr">Wafaa Ei-Sadr</name>
</region>
</country>
<country name="France">
<noRegion>
<name sortKey="Dabis, Francois" sort="Dabis, Francois" uniqKey="Dabis F" first="Francois" last="Dabis">Francois Dabis</name>
</noRegion>
<name sortKey="Dabis, Francois" sort="Dabis, Francois" uniqKey="Dabis F" first="Francois" last="Dabis">Francois Dabis</name>
<name sortKey="Pradier, Christian" sort="Pradier, Christian" uniqKey="Pradier C" first="Christian" last="Pradier">Christian Pradier</name>
</country>
<country name="Belgique">
<region name="Région de Bruxelles-Capitale">
<name sortKey="De Wit, Stephane" sort="De Wit, Stephane" uniqKey="De Wit S" first="Stephane" last="De Wit">Stephane De Wit</name>
</region>
</country>
<country name="Australie">
<region name="Nouvelle-Galles du Sud">
<name sortKey="Law, Mathew G" sort="Law, Mathew G" uniqKey="Law M" first="Mathew G." last="Law">Mathew G. Law</name>
</region>
</country>
<country name="Suisse">
<region name="Canton de Zurich">
<name sortKey="Weber, Rainer" sort="Weber, Rainer" uniqKey="Weber R" first="Rainer" last="Weber">Rainer Weber</name>
</region>
</country>
<country name="Royaume-Uni">
<region name="Angleterre">
<name sortKey="Phillips, Andrew N" sort="Phillips, Andrew N" uniqKey="Phillips A" first="Andrew N." last="Phillips">Andrew N. Phillips</name>
</region>
<name sortKey="Sabin, Caroline A" sort="Sabin, Caroline A" uniqKey="Sabin C" first="Caroline A." last="Sabin">Caroline A. Sabin</name>
</country>
</tree>
</affiliations>
</record>

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