Bilirubin Is Inversely Associated With Cardiovascular Disease Among <styled-content style="fixed-case">HIV</styled-content>‐Positive and <styled-content style="fixed-case">HIV</styled-content>‐Negative Individuals in <styled-content style="fixed-case">VACS</styled-content> (Veterans Aging Cohort Study)

Bilirubin Is Inversely Associated With Cardiovascular Disease Among <styled-content style="fixed-case">HIV</styled-content>‐Positive and <styled-content style="fixed-case">HIV</styled-content>‐Negative Individuals in <styled-content style="fixed-case">VACS</styled-content> (Veterans Aging Cohort Study)

BackgroundBilirubin may protect against cardiovascular disease (CVD) by reducing oxidative stress. Whether elevated bilirubin reduces the risk of CVD events among HIV+ individuals and if this differs from uninfected individuals remain unclear. We assessed whether bilirubin independently predicted th...

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Autores principales: Vincent C. Marconi, Meredith S. Duncan, Kaku So‐Armah, Vincent Lo Re, Joseph K. Lim, Adeel A. Butt, Matthew Bidwell Goetz, Maria C. Rodriguez‐Barradas, Charles W. Alcorn, Jeffrey Lennox, Joshua A. Beckman, Amy Justice, Matthew Freiberg
Formato: article
Lenguaje:EN
Publicado: Wiley 2018
Materias:
cardiovascular disease
bilirubin
HIV
stroke
myocardial infarction
heart failure
Diseases of the circulatory (Cardiovascular) system
RC666-701
Acceso en línea:https://doaj.org/article/620133d24eb4449aaee37cccc94b2059
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spelling oai:doaj.org-article:620133d24eb4449aaee37cccc94b20592021-11-12T17:01:59ZBilirubin Is Inversely Associated With Cardiovascular Disease Among <styled-content style="fixed-case">HIV</styled-content>‐Positive and <styled-content style="fixed-case">HIV</styled-content>‐Negative Individuals in <styled-content style="fixed-case">VACS</styled-content> (Veterans Aging Cohort Study)10.1161/JAHA.117.0077922047-9980https://doaj.org/article/620133d24eb4449aaee37cccc94b20592018-05-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.117.007792https://doaj.org/toc/2047-9980BackgroundBilirubin may protect against cardiovascular disease (CVD) by reducing oxidative stress. Whether elevated bilirubin reduces the risk of CVD events among HIV+ individuals and if this differs from uninfected individuals remain unclear. We assessed whether bilirubin independently predicted the risk of CVD events among HIV+ and uninfected participants in VACS (Veterans Aging Cohort Study). Methods and ResultsWe conducted a prospective cohort study using VACS participants free of baseline CVD. Total bilirubin was categorized by quartiles. CVD as well as acute myocardial infarction, heart failure, and ischemic stroke events were assessed. Cox regression was used to evaluate hazard ratios of outcomes associated with quartiles of total bilirubin in HIV+ and uninfected people after adjusting for multiple risk factors. There were 96 381 participants (30 427 HIV+); mean age was 48 years, 48% were black, and 97% were men. There were 6603 total incident CVD events over a mean of 5.7 years. In adjusted models, increasing quartiles of baseline total bilirubin were associated with decreased hazards of all outcomes (hazard ratio, 0.86; 95% confidence interval, 0.80–0.91). Among HIV+ participants, results persisted for heart failure, ischemic stroke, and total CVD, but nonsignificant associations were observed for acute myocardial infarction. ConclusionsVACS participants (regardless of HIV status) with elevated bilirubin levels had a lower risk of incident total CVD, acute myocardial infarction, heart failure, and ischemic stroke events after adjusting for known risk factors. Future studies should investigate how this apparently protective effect of elevated bilirubin could be harnessed to reduce CVD risk or improve risk estimation among HIV+ individuals.Vincent C. MarconiMeredith S. DuncanKaku So‐ArmahVincent Lo ReJoseph K. LimAdeel A. ButtMatthew Bidwell GoetzMaria C. Rodriguez‐BarradasCharles W. AlcornJeffrey LennoxJoshua A. BeckmanAmy JusticeMatthew FreibergWileyarticlecardiovascular diseasebilirubinHIVstrokemyocardial infarctionheart failureDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 7, Iss 10 (2018)
institution DOAJ
collection DOAJ
language EN
topic cardiovascular disease
bilirubin
HIV
stroke
myocardial infarction
heart failure
Diseases of the circulatory (Cardiovascular) system
RC666-701
spellingShingle cardiovascular disease
bilirubin
HIV
stroke
myocardial infarction
heart failure
Diseases of the circulatory (Cardiovascular) system
RC666-701
Vincent C. Marconi
Meredith S. Duncan
Kaku So‐Armah
Vincent Lo Re
Joseph K. Lim
Adeel A. Butt
Matthew Bidwell Goetz
Maria C. Rodriguez‐Barradas
Charles W. Alcorn
Jeffrey Lennox
Joshua A. Beckman
Amy Justice
Matthew Freiberg
Bilirubin Is Inversely Associated With Cardiovascular Disease Among <styled-content style="fixed-case">HIV</styled-content>‐Positive and <styled-content style="fixed-case">HIV</styled-content>‐Negative Individuals in <styled-content style="fixed-case">VACS</styled-content> (Veterans Aging Cohort Study)
description BackgroundBilirubin may protect against cardiovascular disease (CVD) by reducing oxidative stress. Whether elevated bilirubin reduces the risk of CVD events among HIV+ individuals and if this differs from uninfected individuals remain unclear. We assessed whether bilirubin independently predicted the risk of CVD events among HIV+ and uninfected participants in VACS (Veterans Aging Cohort Study). Methods and ResultsWe conducted a prospective cohort study using VACS participants free of baseline CVD. Total bilirubin was categorized by quartiles. CVD as well as acute myocardial infarction, heart failure, and ischemic stroke events were assessed. Cox regression was used to evaluate hazard ratios of outcomes associated with quartiles of total bilirubin in HIV+ and uninfected people after adjusting for multiple risk factors. There were 96 381 participants (30 427 HIV+); mean age was 48 years, 48% were black, and 97% were men. There were 6603 total incident CVD events over a mean of 5.7 years. In adjusted models, increasing quartiles of baseline total bilirubin were associated with decreased hazards of all outcomes (hazard ratio, 0.86; 95% confidence interval, 0.80–0.91). Among HIV+ participants, results persisted for heart failure, ischemic stroke, and total CVD, but nonsignificant associations were observed for acute myocardial infarction. ConclusionsVACS participants (regardless of HIV status) with elevated bilirubin levels had a lower risk of incident total CVD, acute myocardial infarction, heart failure, and ischemic stroke events after adjusting for known risk factors. Future studies should investigate how this apparently protective effect of elevated bilirubin could be harnessed to reduce CVD risk or improve risk estimation among HIV+ individuals.
format article
author Vincent C. Marconi
Meredith S. Duncan
Kaku So‐Armah
Vincent Lo Re
Joseph K. Lim
Adeel A. Butt
Matthew Bidwell Goetz
Maria C. Rodriguez‐Barradas
Charles W. Alcorn
Jeffrey Lennox
Joshua A. Beckman
Amy Justice
Matthew Freiberg
author_facet Vincent C. Marconi
Meredith S. Duncan
Kaku So‐Armah
Vincent Lo Re
Joseph K. Lim
Adeel A. Butt
Matthew Bidwell Goetz
Maria C. Rodriguez‐Barradas
Charles W. Alcorn
Jeffrey Lennox
Joshua A. Beckman
Amy Justice
Matthew Freiberg
author_sort Vincent C. Marconi
title Bilirubin Is Inversely Associated With Cardiovascular Disease Among <styled-content style="fixed-case">HIV</styled-content>‐Positive and <styled-content style="fixed-case">HIV</styled-content>‐Negative Individuals in <styled-content style="fixed-case">VACS</styled-content> (Veterans Aging Cohort Study)
title_short Bilirubin Is Inversely Associated With Cardiovascular Disease Among <styled-content style="fixed-case">HIV</styled-content>‐Positive and <styled-content style="fixed-case">HIV</styled-content>‐Negative Individuals in <styled-content style="fixed-case">VACS</styled-content> (Veterans Aging Cohort Study)
title_full Bilirubin Is Inversely Associated With Cardiovascular Disease Among <styled-content style="fixed-case">HIV</styled-content>‐Positive and <styled-content style="fixed-case">HIV</styled-content>‐Negative Individuals in <styled-content style="fixed-case">VACS</styled-content> (Veterans Aging Cohort Study)
title_fullStr Bilirubin Is Inversely Associated With Cardiovascular Disease Among <styled-content style="fixed-case">HIV</styled-content>‐Positive and <styled-content style="fixed-case">HIV</styled-content>‐Negative Individuals in <styled-content style="fixed-case">VACS</styled-content> (Veterans Aging Cohort Study)
title_full_unstemmed Bilirubin Is Inversely Associated With Cardiovascular Disease Among <styled-content style="fixed-case">HIV</styled-content>‐Positive and <styled-content style="fixed-case">HIV</styled-content>‐Negative Individuals in <styled-content style="fixed-case">VACS</styled-content> (Veterans Aging Cohort Study)
title_sort bilirubin is inversely associated with cardiovascular disease among <styled-content style="fixed-case">hiv</styled-content>‐positive and <styled-content style="fixed-case">hiv</styled-content>‐negative individuals in <styled-content style="fixed-case">vacs</styled-content> (veterans aging cohort study)
publisher Wiley
publishDate 2018
url https://doaj.org/article/620133d24eb4449aaee37cccc94b2059
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