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Impact of dyslipidemia associated with Highly Active Antiretroviral Therapy (HAART) on cardiovascular risk and life expectancy.
Am J Cardiol 2005; 95(5):586-91AJ

Abstract

We investigated the effect of dyslipidemia associated with highly active antiretroviral therapy on cardiovascular risk and life expectancy among patients who had the human immunodeficiency virus. Dyslipidemia estimates were based on results from a phase 2 randomized trial that compared lipid changes after 32 weeks of therapy with atazanavir with those with nelfinavir (each in combination with stavudine and lamivudine). The resultant increased coronary risk was estimated using Framingham risk equations, and change in life expectancy (after adjustment for mortality due to human immunodeficiency virus) was based on the cardiovascular life expectancy model, which is based on a published Markov's model. Levels of total cholesterol and low-density lipoprotein cholesterol increased significantly more among patients who used nelfinavir (+24% and +28%) than among those who used atazanavir (+4% and +1%). This dyslipidemia increased the risk of coronary disease by 50% over 10 years. The absence of dyslipidemia was estimated to preserve life expectancy 0.15 to 1.53 additional years depending on a patient's age, gender, and other risk factors. There are increasing reports of dyslipidemia and cardiovascular events associated with highly active antiretroviral therapy. Significant increases in blood lipid levels observed with some protease inhibitors are associated with an increase in calculated 10-year coronary risk. Accordingly, minimizing dyslipidemia associated with highly active antiretroviral therapy may preserve life expectancy among adults who have the human immunodeficiency virus.

Authors+Show Affiliations

Centre for the Analysis of Cost-Effective Care, Divisions of General Internal Medicine and Clinical Epidemiology, The Montreal General Hospital, Department of Medicine, McGill University, Montreal, Quebec, Canada. steven.grover@mcgill.caNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15721096

Citation

Grover, Steven A., et al. "Impact of Dyslipidemia Associated With Highly Active Antiretroviral Therapy (HAART) On Cardiovascular Risk and Life Expectancy." The American Journal of Cardiology, vol. 95, no. 5, 2005, pp. 586-91.
Grover SA, Coupal L, Gilmore N, et al. Impact of dyslipidemia associated with Highly Active Antiretroviral Therapy (HAART) on cardiovascular risk and life expectancy. Am J Cardiol. 2005;95(5):586-91.
Grover, S. A., Coupal, L., Gilmore, N., & Mukherjee, J. (2005). Impact of dyslipidemia associated with Highly Active Antiretroviral Therapy (HAART) on cardiovascular risk and life expectancy. The American Journal of Cardiology, 95(5), pp. 586-91.
Grover SA, et al. Impact of Dyslipidemia Associated With Highly Active Antiretroviral Therapy (HAART) On Cardiovascular Risk and Life Expectancy. Am J Cardiol. 2005 Mar 1;95(5):586-91. PubMed PMID: 15721096.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of dyslipidemia associated with Highly Active Antiretroviral Therapy (HAART) on cardiovascular risk and life expectancy. AU - Grover,Steven A, AU - Coupal,Louis, AU - Gilmore,Norbert, AU - Mukherjee,Jayanti, PY - 2004/08/16/received PY - 2004/11/09/revised PY - 2004/11/09/accepted PY - 2005/2/22/pubmed PY - 2005/3/25/medline PY - 2005/2/22/entrez SP - 586 EP - 91 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 95 IS - 5 N2 - We investigated the effect of dyslipidemia associated with highly active antiretroviral therapy on cardiovascular risk and life expectancy among patients who had the human immunodeficiency virus. Dyslipidemia estimates were based on results from a phase 2 randomized trial that compared lipid changes after 32 weeks of therapy with atazanavir with those with nelfinavir (each in combination with stavudine and lamivudine). The resultant increased coronary risk was estimated using Framingham risk equations, and change in life expectancy (after adjustment for mortality due to human immunodeficiency virus) was based on the cardiovascular life expectancy model, which is based on a published Markov's model. Levels of total cholesterol and low-density lipoprotein cholesterol increased significantly more among patients who used nelfinavir (+24% and +28%) than among those who used atazanavir (+4% and +1%). This dyslipidemia increased the risk of coronary disease by 50% over 10 years. The absence of dyslipidemia was estimated to preserve life expectancy 0.15 to 1.53 additional years depending on a patient's age, gender, and other risk factors. There are increasing reports of dyslipidemia and cardiovascular events associated with highly active antiretroviral therapy. Significant increases in blood lipid levels observed with some protease inhibitors are associated with an increase in calculated 10-year coronary risk. Accordingly, minimizing dyslipidemia associated with highly active antiretroviral therapy may preserve life expectancy among adults who have the human immunodeficiency virus. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/15721096/Impact_of_dyslipidemia_associated_with_Highly_Active_Antiretroviral_Therapy__HAART__on_cardiovascular_risk_and_life_expectancy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(04)01775-8 DB - PRIME DP - Unbound Medicine ER -