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Erschienen in: Infection 5/2016

05.04.2016 | Original Paper

Statins and Aspirin use in HIV-infected people: gap between European AIDS Clinical Society guidelines and clinical practice: the results from HIV-HY study

verfasst von: Giuseppe Vittorio De Socio, Elena Ricci, Giustino Parruti, Leonardo Calza, Paolo Maggi, Benedetto Maurizio Celesia, Giancarlo Orofino, Giordano Madeddu, Canio Martinelli, Barbara Menzaghi, Lucia Taramasso, Giovanni Penco, Laura Carenzi, Marco Franzetti, Paolo Bonfanti

Erschienen in: Infection | Ausgabe 5/2016

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Abstract

Objectives

To investigate the use of statins and acetylsalicylic acid (ASA) in HIV people in clinical practice.

Design

A multicenter, nationwide, prospective cohort study, including 1182 consecutive HIV patients was conducted.

Methods

Statin and ASA prescription was evaluated in primary and secondary cardiovascular disease prevention, according to the European AIDS Clinical Society (EACS) guidelines.

Results

Followed-up patients (998) were mostly males (70.9 %) with a mean age at enrolment of 46.5 years (SD 9.5). The mean time of follow-up was 3.3 years (SD 0.8). At the last follow-up visit, statins would have been recommended for 31.2 % and ASA for 16 % by EACS guidelines. Conversely, only 15.6 and 7.6 % of patients were on statin and ASA treatment, respectively; only 50.3 % of patients treated with statins achieved recommended low-density lipoprotein cholesterol (LDL-c) levels. At the last follow-up visit, agreement between statin therapy and EACS recommendation was 0.58 (95 % CI 0.52–0.63). The corresponding figure for ASA therapy was 0.50 (95 % CI 0.42–0.58), whereas the agreement for ASA therapy in secondary prevention was 0.59 (95 % CI 0.50–0.68).

Conclusions

The prescription of statins and ASA in HIV-infected patients remains largely suboptimal, as only about 50 % of patients requiring statins and ASA are properly treated. Higher attention on this relevant issue and further investigation are warranted in this at risk population.
Literatur
1.
Zurück zum Zitat Currier JS, Lundgren JD, Carr A, et al. Epidemiological evidence for cardiovascular disease in HIV infected patients and relationship to highly active antiretroviral therapy. Circulation. 2008;118:e29–35.CrossRefPubMed Currier JS, Lundgren JD, Carr A, et al. Epidemiological evidence for cardiovascular disease in HIV infected patients and relationship to highly active antiretroviral therapy. Circulation. 2008;118:e29–35.CrossRefPubMed
2.
Zurück zum Zitat De Socio GV, Martinelli L, Morosi S, et al. Is estimated cardiovascular risk higher in HIV-infected patients than in the general population? Scand J Infect Dis. 2007;39:805–12.CrossRefPubMed De Socio GV, Martinelli L, Morosi S, et al. Is estimated cardiovascular risk higher in HIV-infected patients than in the general population? Scand J Infect Dis. 2007;39:805–12.CrossRefPubMed
3.
Zurück zum Zitat Bonfanti P, De Socio GL, Marconi P, et al. Is metabolic syndrome associated to HIV infection per se? Results from the HERMES study. Curr HIV Res. 2010;8:165–71.CrossRefPubMed Bonfanti P, De Socio GL, Marconi P, et al. Is metabolic syndrome associated to HIV infection per se? Results from the HERMES study. Curr HIV Res. 2010;8:165–71.CrossRefPubMed
4.
Zurück zum Zitat Bonfanti P, De Socio GV, Ricci E, et al. The feature of Metabolic Syndrome in HIV naive patients is not the same of those treated: results from a prospective study. Biomed Pharmacother. 2012;66:348–53.CrossRefPubMed Bonfanti P, De Socio GV, Ricci E, et al. The feature of Metabolic Syndrome in HIV naive patients is not the same of those treated: results from a prospective study. Biomed Pharmacother. 2012;66:348–53.CrossRefPubMed
6.
Zurück zum Zitat Günthard HF, Aberg JA, Eron JJ, et al. Antiretroviral treatment of adult HIV infection: 2014 recommendations of the international antiviral society—USA Panel. JAMA. 2014;312:410–25.CrossRefPubMed Günthard HF, Aberg JA, Eron JJ, et al. Antiretroviral treatment of adult HIV infection: 2014 recommendations of the international antiviral society—USA Panel. JAMA. 2014;312:410–25.CrossRefPubMed
7.
Zurück zum Zitat Feinstein MJ, Achenbach CJ, Stone NJ, Lloyd-Jones DM. A systematic review of the usefulness of statin therapy in HIV-infected patients. Am J Cardiol. 2015;115:1760–6.CrossRefPubMed Feinstein MJ, Achenbach CJ, Stone NJ, Lloyd-Jones DM. A systematic review of the usefulness of statin therapy in HIV-infected patients. Am J Cardiol. 2015;115:1760–6.CrossRefPubMed
8.
Zurück zum Zitat Burkholder GA, Tamhane AR, Salinas JL, et al. Underutilization of aspirin for primary prevention of cardiovascular disease among HIV-infected patients. Clin Infect Dis. 2012;55:1550–7.CrossRefPubMedPubMedCentral Burkholder GA, Tamhane AR, Salinas JL, et al. Underutilization of aspirin for primary prevention of cardiovascular disease among HIV-infected patients. Clin Infect Dis. 2012;55:1550–7.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Tornero C, Ventura A, Mafe M. Aspirin is indicated for primary prevention of cardiovascular events in HIV-infected patients. J Acquir Immune Defic Syndr. 2010;54:560.CrossRefPubMed Tornero C, Ventura A, Mafe M. Aspirin is indicated for primary prevention of cardiovascular events in HIV-infected patients. J Acquir Immune Defic Syndr. 2010;54:560.CrossRefPubMed
10.
Zurück zum Zitat De Socio GV, Ricci E, Maggi P, et al. CISAI Study Group. Prevalence, awareness, treatment, and control rate of hypertension in HIV-infected patients: the HIV-HY study. Am J Hypertens. 2014;27:222–8.CrossRefPubMed De Socio GV, Ricci E, Maggi P, et al. CISAI Study Group. Prevalence, awareness, treatment, and control rate of hypertension in HIV-infected patients: the HIV-HY study. Am J Hypertens. 2014;27:222–8.CrossRefPubMed
11.
Zurück zum Zitat Mancia G, De Backer G, Dominiczak A, Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology, et al. 2007 Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the european society of hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–87 (Erratum in: J Hypertens 2007;25:1749).CrossRefPubMed Mancia G, De Backer G, Dominiczak A, Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology, et al. 2007 Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the european society of hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007;25:1105–87 (Erratum in: J Hypertens 2007;25:1749).CrossRefPubMed
12.
Zurück zum Zitat The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003;26:3160–67. The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus: Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 2003;26:3160–67.
13.
Zurück zum Zitat Expert Panel on Detection. Evaluation, and treatment of high blood cholesterol in adults. executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–97.CrossRef Expert Panel on Detection. Evaluation, and treatment of high blood cholesterol in adults. executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486–97.CrossRef
14.
Zurück zum Zitat Seshasai SR, Wijesuriya S, Sivakumaran R, et al. Effect of aspirin on vascular and nonvascular outcomes: meta-analysis of randomized controlled trials. Arch Intern Med. 2012;172:209–16.CrossRefPubMed Seshasai SR, Wijesuriya S, Sivakumaran R, et al. Effect of aspirin on vascular and nonvascular outcomes: meta-analysis of randomized controlled trials. Arch Intern Med. 2012;172:209–16.CrossRefPubMed
15.
Zurück zum Zitat Rapezzi C, Biagini E, Bellis P et al.; EASY Investigators. Exploring the gap between national cholesterol education program guidelines and clinical practice in secondary care: results of a cross-sectional study involving over 10,000 patients followed in different specialty settings across Italy. J Cardiovasc Med (Hagerstown). 2008;9:878–87. Rapezzi C, Biagini E, Bellis P et al.; EASY Investigators. Exploring the gap between national cholesterol education program guidelines and clinical practice in secondary care: results of a cross-sectional study involving over 10,000 patients followed in different specialty settings across Italy. J Cardiovasc Med (Hagerstown). 2008;9:878–87.
16.
Zurück zum Zitat Taylor F, Huffman MD, Macedo AF et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013;1:CD004816. Taylor F, Huffman MD, Macedo AF et al. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013;1:CD004816.
17.
Zurück zum Zitat Calza L, Vanino E, Salvadori C, Manfredi R, Colangeli V, Cascavilla A, Di Bari MA, Motta R, Viale P. Tenofovir/emtricitabine/efavirenz plus rosuvastatin decrease serum levels of inflammatory markers more than antiretroviral drugs alone in antiretroviral therapy-naive HIV-infected patients. HIV Clin Trials. 2014;15:1–13.CrossRefPubMed Calza L, Vanino E, Salvadori C, Manfredi R, Colangeli V, Cascavilla A, Di Bari MA, Motta R, Viale P. Tenofovir/emtricitabine/efavirenz plus rosuvastatin decrease serum levels of inflammatory markers more than antiretroviral drugs alone in antiretroviral therapy-naive HIV-infected patients. HIV Clin Trials. 2014;15:1–13.CrossRefPubMed
18.
Zurück zum Zitat Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the american college of cardiology/American heart association task force on practice guidelines. J Am Coll Cardiol. 2014;63:2889–934.CrossRefPubMed Stone NJ, Robinson J, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the american college of cardiology/American heart association task force on practice guidelines. J Am Coll Cardiol. 2014;63:2889–934.CrossRefPubMed
20.
Zurück zum Zitat Russo MW, Hoofnagle JH, Gu J, et al. Spectrum of statin hepatotoxicity: experience of the drug-induced liver injury network. Hepatology. 2014;60:679–86.CrossRefPubMedPubMedCentral Russo MW, Hoofnagle JH, Gu J, et al. Spectrum of statin hepatotoxicity: experience of the drug-induced liver injury network. Hepatology. 2014;60:679–86.CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Naderi SH, Bestwick JP, Wald DS. Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 patients. Am J Med. 2012;125:882–7.CrossRefPubMed Naderi SH, Bestwick JP, Wald DS. Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 patients. Am J Med. 2012;125:882–7.CrossRefPubMed
22.
Zurück zum Zitat Cherubini A, Palomba A, Morosin M, Russo G, Mazzone C, Barbati G, Tarantini L, Cioffi G, Cattin L, Sinagra G, Di Lenarda A. Achieving optimal cholesterol levels in patients with chronic ischemic heart disease: from guidelines to the real world. G Ital Cardiol (Rome). 2015;16:240–9. Cherubini A, Palomba A, Morosin M, Russo G, Mazzone C, Barbati G, Tarantini L, Cioffi G, Cattin L, Sinagra G, Di Lenarda A. Achieving optimal cholesterol levels in patients with chronic ischemic heart disease: from guidelines to the real world. G Ital Cardiol (Rome). 2015;16:240–9.
23.
Zurück zum Zitat Pirro M, Del Giorno R, Lupattelli G, et al. Cardiovascular risk factors and recommended lipid goals attainment among patients referred in a tertiary care lipid clinic. Eur J Intern Med. 2011;22:412–7.CrossRefPubMed Pirro M, Del Giorno R, Lupattelli G, et al. Cardiovascular risk factors and recommended lipid goals attainment among patients referred in a tertiary care lipid clinic. Eur J Intern Med. 2011;22:412–7.CrossRefPubMed
24.
Zurück zum Zitat De Socio GV, Martinelli C, Ricci E, et al. HERMES study group. Relations between cardiovascular risk estimates and subclinical atherosclerosis in naive HIV patients: results from the HERMES study. Int J STD AIDS. 2010;21:267–72.CrossRefPubMed De Socio GV, Martinelli C, Ricci E, et al. HERMES study group. Relations between cardiovascular risk estimates and subclinical atherosclerosis in naive HIV patients: results from the HERMES study. Int J STD AIDS. 2010;21:267–72.CrossRefPubMed
25.
Zurück zum Zitat Maggi P, Quirino T, Ricci E, et al. Cardiovascular risk assessment in antiretroviral-naïve HIV patients. AIDS Patient Care STDS. 2009;23:809–13.CrossRefPubMed Maggi P, Quirino T, Ricci E, et al. Cardiovascular risk assessment in antiretroviral-naïve HIV patients. AIDS Patient Care STDS. 2009;23:809–13.CrossRefPubMed
26.
Zurück zum Zitat US Preventive Services Task Force. Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;150:396–404.CrossRef US Preventive Services Task Force. Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;150:396–404.CrossRef
27.
Zurück zum Zitat Antithrombotic Trialists’ Collaboration Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324:71–86. Antithrombotic Trialists’ Collaboration Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324:71–86.
28.
Zurück zum Zitat Kotseva K, Wood D, De Backer G, De Bacquer D, EUROASPIRE III Study Group. Use and effects of cardiac rehabilitation in patients with coronary heart disease: results from the EUROASPIRE III survey. Eur J Prev Cardiol. 2013;20:817–26.CrossRefPubMed Kotseva K, Wood D, De Backer G, De Bacquer D, EUROASPIRE III Study Group. Use and effects of cardiac rehabilitation in patients with coronary heart disease: results from the EUROASPIRE III survey. Eur J Prev Cardiol. 2013;20:817–26.CrossRefPubMed
29.
Zurück zum Zitat Filippi A, Bianchi C, Parazzini F, et al. A national survey on aspirin patterns of use and persistence in community outpatients in Italy. Eur J Cardiovasc Prev Rehabil. 2011;18:695–703.CrossRefPubMed Filippi A, Bianchi C, Parazzini F, et al. A national survey on aspirin patterns of use and persistence in community outpatients in Italy. Eur J Cardiovasc Prev Rehabil. 2011;18:695–703.CrossRefPubMed
30.
Zurück zum Zitat Schillaci G, Maggi P, Madeddu G, et al. CISAI Study Group. Symmetric ambulatory arterial stiffness index and 24-h pulse pressure in HIV infection: results of a nationwide cross-sectional study. J Hypertens. 2013;31:560–7.CrossRefPubMed Schillaci G, Maggi P, Madeddu G, et al. CISAI Study Group. Symmetric ambulatory arterial stiffness index and 24-h pulse pressure in HIV infection: results of a nationwide cross-sectional study. J Hypertens. 2013;31:560–7.CrossRefPubMed
31.
Zurück zum Zitat De Socio GV, Bonfanti P, Martinelli C, et al. Negative influence of HIV infection on day-night blood pressure variability. J Acquir Immune Defic Syndr. 2010;55:356–60.CrossRefPubMed De Socio GV, Bonfanti P, Martinelli C, et al. Negative influence of HIV infection on day-night blood pressure variability. J Acquir Immune Defic Syndr. 2010;55:356–60.CrossRefPubMed
32.
Zurück zum Zitat De Socio GV, Parruti G, Ricci E, et al. CISAI study group. Decreasing cardiovascular risk in HIV infection between 2005 and 2011. AIDS. 2014;28:609–12.CrossRefPubMed De Socio GV, Parruti G, Ricci E, et al. CISAI study group. Decreasing cardiovascular risk in HIV infection between 2005 and 2011. AIDS. 2014;28:609–12.CrossRefPubMed
33.
Zurück zum Zitat Calcagno A, Nozza S, Mussi C, et al. Ageing with HIV: a multidisciplinary review. Infection. 2015;43:509–22.CrossRefPubMed Calcagno A, Nozza S, Mussi C, et al. Ageing with HIV: a multidisciplinary review. Infection. 2015;43:509–22.CrossRefPubMed
34.
Zurück zum Zitat Guaraldi G, Zona S, Brothers TD, Carli F, Stentarelli C, Dolci G, Santoro A, Beghetto B, Menozzi M, Mussini C, Falutz J. Aging with HIV vs. HIV seroconversion at older age: a diverse population with distinct comorbidity profiles. PLoS One. 2015;10:e0118531.CrossRefPubMedPubMedCentral Guaraldi G, Zona S, Brothers TD, Carli F, Stentarelli C, Dolci G, Santoro A, Beghetto B, Menozzi M, Mussini C, Falutz J. Aging with HIV vs. HIV seroconversion at older age: a diverse population with distinct comorbidity profiles. PLoS One. 2015;10:e0118531.CrossRefPubMedPubMedCentral
Metadaten
Titel
Statins and Aspirin use in HIV-infected people: gap between European AIDS Clinical Society guidelines and clinical practice: the results from HIV-HY study
verfasst von
Giuseppe Vittorio De Socio
Elena Ricci
Giustino Parruti
Leonardo Calza
Paolo Maggi
Benedetto Maurizio Celesia
Giancarlo Orofino
Giordano Madeddu
Canio Martinelli
Barbara Menzaghi
Lucia Taramasso
Giovanni Penco
Laura Carenzi
Marco Franzetti
Paolo Bonfanti
Publikationsdatum
05.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Infection / Ausgabe 5/2016
Print ISSN: 0300-8126
Elektronische ISSN: 1439-0973
DOI
https://doi.org/10.1007/s15010-016-0893-z

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