Predictors of Ischemic and Hemorrhagic Strokes Among People Living With HIV: The D:A:D International Prospective Multicohort Study
| dc.rights.license | open | en_US |
| dc.contributor.author | HATLEBERG, C. I. | |
| dc.contributor.author | RYOM, L. | |
| dc.contributor.author | KAMARA, D. | |
| dc.contributor.author | DE WIT, S. | |
| dc.contributor.author | LAW, M. | |
| dc.contributor.author | PHILLIPS, A. | |
| dc.contributor.author | REISS, P. | |
| dc.contributor.author | D'ARMINIO MONFORTE, A. | |
| dc.contributor.author | MOCROFT, A. | |
| dc.contributor.author | PRADIER, C. | |
| dc.contributor.author | KIRK, O. | |
| dc.contributor.author | KOVARI, H. | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | BONNET, Fabrice | |
| dc.contributor.author | EL-SADR, W. | |
| dc.contributor.author | LUNDGREN, J. D. | |
| dc.contributor.author | SABIN, C. | |
| dc.date.accessioned | 2020-06-23T09:15:36Z | |
| dc.date.available | 2020-06-23T09:15:36Z | |
| dc.date.issued | 2019-08-11 | |
| dc.identifier.issn | 2589-5370 | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/8103 | |
| dc.description.abstractEn | Background: Hypertension is a stronger predictor of hemorrhagic than ischemic strokes in the general population. We aimed to identify whether hypertension or other risk factors, including HIV-related factors, differ in their associations with stroke subtypes in people living with HIV (PLWHIV). Methods: HIV-1-positive individuals from the Data collection on Adverse events of anti-HIV Drugs (D:A:D) study were followed from the time of first blood pressure (BP) measurement after 1/1/1999 or study entry until the first of a validated stroke, 6months after last follow-up or 1/2/2014. Stroke events were centrally validated using standardized criteria. Hypertension was defined as one systolic BP >/= 140mmHg and/or diastolic BP >/= 90mmHg. Poisson and Cox proportional hazards regression models determined associations of established cerebro/cardiovascular disease and HIV-related risk factors with stroke and tested whether these differed by stroke subtype. Findings: 590 strokes (83 hemorrhagic, 296 ischemic, 211 unknown) occurred over 339,979person-years (PYRS) (incidence rate/1000PYRS 1.74 [95% confidence interval (CI) 1.60-1.88]). Common predictors of both hemorrhagic and ischemic strokes were hypertension (relative hazard 3.55 [95% CI 2.29-5.50] and 2.24 [1.77-2.84] respectively) and older age (1.28 [1.17-1.39] and 1.19 [1.12-1.25]). Male gender (1.62 [1.14-2.31] and 0.60 [0.35-0.91]), previous cardiovascular events (4.03 [2.91-5.57] and 1.44 [0.66-3.16]) and smoking (1.90 [1.41-2.56] and 1.08 [0.68-1.71]) were stronger predictors of ischemic then hemorrhagic strokes, whereas hypertension, hepatitis C (1.32 [0.72-2.40] and 0.46 [0.30-0.70]) and estimated glomerular filtration rate < 60mL/min/1.72m(3) (4.80 [2.47-9.36] and 1.04 [0.67-1.60]) were stronger predictors of hemorrhagic than ischemic strokes. A CD4 count < 200cells/muL was associated with an increased risk of hemorrhagic stroke only. Interpretation: Risk factors for stroke may differ by subtype in PLWHIV, emphasizing the importance of further research to increase the precision of stroke risk estimation. | |
| dc.language.iso | EN | en_US |
| dc.rights | Attribution-NonCommercial-NoDerivs 3.0 Unported | |
| dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/3.0/ | |
| dc.subject.en | MORPH3Eus | |
| dc.subject.en | DAD | |
| dc.title.en | Predictors of Ischemic and Hemorrhagic Strokes Among People Living With HIV: The D:A:D International Prospective Multicohort Study | |
| dc.title.alternative | EClinicalMedicine | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1016/j.eclinm.2019.07.008 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
| dc.identifier.pubmed | 31517266 | en_US |
| bordeaux.journal | EClinicalMedicine | en_US |
| bordeaux.page | 91-100 | en_US |
| bordeaux.volume | 13 | en_US |
| bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.identifier | hal-03210837 | |
| hal.version | 1 | |
| hal.date.transferred | 2021-04-28T08:52:07Z | |
| hal.export | true | |
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