227 - HIV patients in the glaring light of the new ESC Dyslipidaemias 2019 Guidelines. Unattainable goals or a therapeutic nihilism? (ID 473)
Abstract
Background and Aims
Over past 20 years we observe tripling of HIV-associated cardiovascular diseases due to HAART and prolonged life expectancy. Aims of the study were to analyze HIV patients’ lipid parameters and hypolipemic treatment in relation to ESC 2019 Guidelines.
Methods
Retrospective analysis of 388 HIV-infected patients was performed based on medical records. Following PTN AIDS recommendations, all HIV patients without other cardiovascular risk factors were assigned to high cardiovascular risk (HCvR, n=350), while patients with additional risk factors were considered as very high cardiovascular risk individuals (VHCvR, n=38).
Results
Mean doses of statins among HCvR HIV patients were 8.1mg of rosuwastatin and 18.9mg atorvastatin respectively. Average LDL in HCvR HIV patients was 104,49±32 mg/dl. Detailed reachability of therapeutic LDL was featured in Fig.1. HCvR patients on hypolypemic treatment had significantly higher Tch, TG, non-HDL and AIP levels in comparison to patients without lipid lowering therapy (Tab.1).
Mean doses of statins among VHCvR HIV patients were: 13.6mg for rozuwastatin and 26mg for atorwastatin. Mean LDL level was 97,53±25mg/dl. Therapeutic LDL reachability was featured in Fig.1.
15 (3,86%) of HIV patients experienced cardiovascular incidents. Mean age during incident was 41.3±10years.
Conclusions
The reachability of therapeutic LDLs among HIV patients remains unsatisfactory. Only 10.6% of patients reach therapeutic LDLs. Worse lipid parameters in patients during hypolipemic treatment and low mean statin doses along with relatively young mean age during cardiovascular incidents suggest that HIV patients are not being properly managed. Much more attention should be paid to this relatively new group of patients with increased cardiovascular risk.
