AustralieFrV1, Main, Exploration, bibRecord, 006F00

Prevalence and Prognostic Significance of ECG Abnormalities in HIV-infected Patients: Results from the Strategies for Management of Antiretroviral Therapy (SMART) Study

Identifieur interne : 006F00 ( Main/Exploration ); précédent : 006E99; suivant : 006F01

Prevalence and Prognostic Significance of ECG Abnormalities in HIV-infected Patients: Results from the Strategies for Management of Antiretroviral Therapy (SMART) Study

Auteurs : Elsayed Z. Soliman [États-Unis] ; Ronald J. Prineas [États-Unis] ; Mollie P. Roediger [États-Unis] ; Daniel A. Duprez [États-Unis] ; Franck Boccara [France] ; Christoph Boesecke [Australie] ; Christoph Stephan [Allemagne] ; Sally Hodder [États-Unis] ; James H. Stein [États-Unis] ; Jens D. Lundgren [Danemark] ; James D. Neaton [États-Unis]

Source :

Journal of electrocardiology [ 0022-0736 ] ; 2010.

RBID : PMC:3060290

Abstract

Background

It remains debated whether to include resting electrocardiogram (ECG) in the routine care of patients infected with Human immunodeficiency virus (HIV). This is largely because data are limited regarding the prevalence and prognostic significance of ECG abnormalities in HIV-infected patients.

Methods

This analysis included 4518 HIV-infected patients (28% females and 29% blacks) from The Strategies for Management of Antiretroviral Therapy (SMART) study, a clinical trial aimed to compare two HIV treatment strategies. ECG abnormalities were classified using the Minnesota Code. Multivariable adjusted Cox proportional hazards analysis was used to examine the association between baseline ECG abnormalities and incident cardiovascular disease.

Results

More than half of the participants (N=2325, 51.5%) had either minor or major ECG abnormalities. Minor ECG abnormalities (48.6%) were more common than major ECG abnormalities (7.7%). During a median follow-up of 28.7 months, 155 (3.4%) participants developed incident cardiovascular disease. After adjusting for the study treatment arms, the presence of major, minor, and either minor or major ECG abnormalities were significantly predictive of incident cardiovascular disease [Hazard ratio (95% Confidence Interval): 2.76 (1.74, 4.39), p<0.001; 1.58 (1.14, 2.20), p=0.006; 1.57 (1.14, 2.18), p=0.006, respectively]. However, after adjusting for demographics, common cardiovascular risk factors and HIV characteristics (full model), presence of major ECG abnormalities was still significantly predictive of cardiovascular disease [1.83 (1.12, 2.97), p=0.015)], but not minor or minor or major abnormalities taken together [1.26 (0.89, 1.79), p=0.18; 1.25 (0.89, 1.76), p=0.20, respectively]. Individual ECG abnormalities that significantly predicted cardiovascular disease in the fully adjusted model included major isolated ST/T abnormalities, major prolongation of QT interval, minor isolated ST/T and minor isolated Q/QS abnormalities.

Conclusion

Nearly one in two of the HIV-infected patients in SMART study had ECG abnormalities; one in thirteen had major ECG abnormalities. Presence of ECG abnormalities, especially major ECG abnormalities was independently predictive of incident cardiovascular disease. These results suggest that the ECG could provide a convenient risk screening tool in HIV-infected patients.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3060290

DOI: 10.1016/j.jelectrocard.2010.10.027
PubMed: 21145066
PubMed Central: 3060290

Affiliations:

Le document en format XML

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<author><name sortKey="Hodder, Sally" sort="Hodder, Sally" uniqKey="Hodder S" first="Sally" last="Hodder">Sally Hodder</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">New Jersey</region>
</placeName>
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<country xml:lang="fr">États-Unis</country>
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<author><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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<wicri:regionArea>Copenhagen HIV Programme (CHIP), State University Hospital and University of Copenhagen, Copenhagen</wicri:regionArea>
<placeName><settlement type="city">Copenhague</settlement>
<region type="région" nuts="2">Hovedstaden</region>
</placeName>
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<author><name sortKey="Neaton, James D" sort="Neaton, James D" uniqKey="Neaton J" first="James D" last="Neaton">James D. Neaton</name>
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<series><title level="j">Journal of electrocardiology</title>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">It remains debated whether to include resting electrocardiogram (ECG) in the routine care of patients infected with Human immunodeficiency virus (HIV). This is largely because data are limited regarding the prevalence and prognostic significance of ECG abnormalities in HIV-infected patients.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">This analysis included 4518 HIV-infected patients (28% females and 29% blacks) from The Strategies for Management of Antiretroviral Therapy (SMART) study, a clinical trial aimed to compare two HIV treatment strategies. ECG abnormalities were classified using the Minnesota Code. Multivariable adjusted Cox proportional hazards analysis was used to examine the association between baseline ECG abnormalities and incident cardiovascular disease.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">More than half of the participants (N=2325, 51.5%) had either minor or major ECG abnormalities. Minor ECG abnormalities (48.6%) were more common than major ECG abnormalities (7.7%). During a median follow-up of 28.7 months, 155 (3.4%) participants developed incident cardiovascular disease. After adjusting for the study treatment arms, the presence of major, minor, and either minor or major ECG abnormalities were significantly predictive of incident cardiovascular disease [Hazard ratio (95% Confidence Interval): 2.76 (1.74, 4.39), p<0.001; 1.58 (1.14, 2.20), p=0.006; 1.57 (1.14, 2.18), p=0.006, respectively]. However, after adjusting for demographics, common cardiovascular risk factors and HIV characteristics (full model), presence of major ECG abnormalities was still significantly predictive of cardiovascular disease [1.83 (1.12, 2.97), p=0.015)], but not minor or minor or major abnormalities taken together [1.26 (0.89, 1.79), p=0.18; 1.25 (0.89, 1.76), p=0.20, respectively]. Individual ECG abnormalities that significantly predicted cardiovascular disease in the fully adjusted model included major isolated ST/T abnormalities, major prolongation of QT interval, minor isolated ST/T and minor isolated Q/QS abnormalities.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">Nearly one in two of the HIV-infected patients in SMART study had ECG abnormalities; one in thirteen had major ECG abnormalities. Presence of ECG abnormalities, especially major ECG abnormalities was independently predictive of incident cardiovascular disease. These results suggest that the ECG could provide a convenient risk screening tool in HIV-infected patients.</p>
</sec>
</div>
</front>
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<affiliations><list><country><li>Allemagne</li>
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<name sortKey="Neaton, James D" sort="Neaton, James D" uniqKey="Neaton J" first="James D" last="Neaton">James D. Neaton</name>
<name sortKey="Prineas, Ronald J" sort="Prineas, Ronald J" uniqKey="Prineas R" first="Ronald J" last="Prineas">Ronald J. Prineas</name>
<name sortKey="Roediger, Mollie P" sort="Roediger, Mollie P" uniqKey="Roediger M" first="Mollie P" last="Roediger">Mollie P. Roediger</name>
<name sortKey="Stein, James H" sort="Stein, James H" uniqKey="Stein J" first="James H" last="Stein">James H. Stein</name>
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<country name="France"><noRegion><name sortKey="Boccara, Franck" sort="Boccara, Franck" uniqKey="Boccara F" first="Franck" last="Boccara">Franck Boccara</name>
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<country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Boesecke, Christoph" sort="Boesecke, Christoph" uniqKey="Boesecke C" first="Christoph" last="Boesecke">Christoph Boesecke</name>
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</country>
<country name="Allemagne"><region name="Hesse (Land)"><name sortKey="Stephan, Christoph" sort="Stephan, Christoph" uniqKey="Stephan C" first="Christoph" last="Stephan">Christoph Stephan</name>
</region>
</country>
<country name="Danemark"><region name="Hovedstaden"><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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Prevalence and Prognostic Significance of ECG Abnormalities in HIV-infected Patients: Results from the Strategies for Management of Antiretroviral Therapy (SMART) Study

Prevalence and Prognostic Significance of ECG Abnormalities in HIV-infected Patients: Results from the Strategies for Management of Antiretroviral Therapy (SMART) Study

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Abstract

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	Serveur d'exploration sur les relations entre la France et l'Australie
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