Cardiovascular Risk, Statin Use and Electrocardiogram in HIV Patients

Abstract

Introduction: Non-infectious complications became more frequent in patients living with the Human Immunodeficiency Virus (HIV). Dyslipidemia is common and represents an important cardiovascular risk factor in this population. Therefore, cardiovascular diseases represent one of the main causes of HIV morbidity and mortality. Objective: This study aimed to assess cardiovascular risk and electrocardiographic changes in outpatients living with HIV. Methods: We performed a single-center cross-sectional study that included HIV patients who were at least 30 years old and had HIV diagnosis for more than one year. Patients were on regular follow-up in a tertiary center in Brazil. Cardiovascular risk was assessed using the Global Risk Score (GRS), as recommended by Brazilian guidelines. Cardiovascular risk factors, lipid profile, statin use and resting electrocardiogram were also analyzed. Results: 92 patients were included, with an average age of 48.9 years. 54 (58.7%) were male, 28 (30.4%) had hypertension, 10 (10.9%) had type 2 diabetes mellitus, 9 (9.8%) were current smokers, and 25 (27.2%) had a previous diagnosis of dyslipidemia. Average LDL-cholesterol level was 120.2 ± 40.6 mg/dl. Eleven patients (11.9%) were on statin therapy. High cardiovascular risk was identified in 28 patients (30.4%) and only seven of those (25.0%) were on statin therapy. Serum LDL-cholesterol higher than or equal to 130 mg/dl was found in 31 patients (33.7%), and only seven of those (22.6%) were on statin therapy. ECG changes were found in 21.7%, mostly due to conduction disturbances (17.4%). Conclusion: We found a high prevalence of HIV outpatients with high cardiovascular risk. Only one in every four patients with this characteristic was on statin therapy. Cardiovascular risk is one of the main concerns in the HIV population, once antiretroviral therapy succeeds to reduce mortality attributed to opportunistic infections.