Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study.
<h4>Background</h4>Psychological factors are known predictors of cardiovascular disease in many clinical settings, but data are lacking for HIV infection. We carried out a prospective cohort study to evaluate potential psychological predictors of preclinical and clinical vascular disease...
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oai:doaj.org-article:8469d23a1ac941f1bb2171a91257ec1a2021-11-18T08:00:35ZPsychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study.1932-620310.1371/journal.pone.0054555https://doaj.org/article/8469d23a1ac941f1bb2171a91257ec1a2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23349927/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Psychological factors are known predictors of cardiovascular disease in many clinical settings, but data are lacking for HIV infection. We carried out a prospective cohort study to evaluate potential psychological predictors of preclinical and clinical vascular disease in HIV patients.<h4>Methodology/principal findings</h4>HIV patients were consecutively enrolled. Demographics, viral and immune parameters and traditional cardiovascular predictors were considered; Intima-Media Thickness (c-IMT, continuous measure) and Carotid Plaques (CPs, focal thickening ≥1.5 mm) were investigated by B-mode ultrasonography; depressive symptoms by the Beck Depression Inventory (BDI-II), Type D personality (Distressed Personality or Type D) by the DS14, alexithymia by the Toronto Alexithymia Scale (TAS-20). Vascular outcomes included transient ischemic attacks or stroke, acute coronary syndrome, myocardial or other organ infarction. We enrolled 232 HIV subjects, 73.9% males, aged 44.5±9.9 y, 38.2% with AIDS diagnosis, 18.3% untreated. Mean Nadir CD4 T-cell counts were 237.5±186.2/mmc. Of them, 224 (96.5%) attended IMT measurements; 201 (86.6%) attended both IMT assessment and psychological profiling. Mean follow-up was 782±308 days. Fifty-nine patients (29.4%) had CPs at baseline. Nineteen patients (9.5%) had ≥1 vascular event; 12 (6.0%) died due to such events (n = 4) or any cause. At baseline cross-sectional multivariate analysis, increasing age, total cholesterol, current smoking and Alexithymia score≥50 were significantly associated with both increased cIMT (linear regression) and CPs (logistic regression). At follow-up analysis, log-rank tests and Cox's regression revealed that only older age (p = 0.001), current smoking (p = 0.019) and alexithymia score≥50 (p = 0.013) were independently associated with vascular events.<h4>Conclusions/significance</h4>In HIV-infected subjects, the Alexithymic trait emerges as a strong predictor of increased IMT, presence of CPs and vascular events. Such results are preliminary and require confirmation from studies with larger sample size and longer follow-up.Giustino ParrutiFrancesco VadiniFederica SozioElena MazzottTamara UrsiniEnnio PolillPaola Di StefanoMonica TontodonatiMaria C VerrocchioMaria C VerrocchioMario FulcheriGiulio CalellaFrancesca SantilliLamberto ManzoliPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 1, p e54555 (2013) |
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Medicine R Science Q Giustino Parruti Francesco Vadini Federica Sozio Elena Mazzott Tamara Ursini Ennio Polill Paola Di Stefano Monica Tontodonati Maria C Verrocchio Maria C Verrocchio Mario Fulcheri Giulio Calella Francesca Santilli Lamberto Manzoli Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study. |
| description |
<h4>Background</h4>Psychological factors are known predictors of cardiovascular disease in many clinical settings, but data are lacking for HIV infection. We carried out a prospective cohort study to evaluate potential psychological predictors of preclinical and clinical vascular disease in HIV patients.<h4>Methodology/principal findings</h4>HIV patients were consecutively enrolled. Demographics, viral and immune parameters and traditional cardiovascular predictors were considered; Intima-Media Thickness (c-IMT, continuous measure) and Carotid Plaques (CPs, focal thickening ≥1.5 mm) were investigated by B-mode ultrasonography; depressive symptoms by the Beck Depression Inventory (BDI-II), Type D personality (Distressed Personality or Type D) by the DS14, alexithymia by the Toronto Alexithymia Scale (TAS-20). Vascular outcomes included transient ischemic attacks or stroke, acute coronary syndrome, myocardial or other organ infarction. We enrolled 232 HIV subjects, 73.9% males, aged 44.5±9.9 y, 38.2% with AIDS diagnosis, 18.3% untreated. Mean Nadir CD4 T-cell counts were 237.5±186.2/mmc. Of them, 224 (96.5%) attended IMT measurements; 201 (86.6%) attended both IMT assessment and psychological profiling. Mean follow-up was 782±308 days. Fifty-nine patients (29.4%) had CPs at baseline. Nineteen patients (9.5%) had ≥1 vascular event; 12 (6.0%) died due to such events (n = 4) or any cause. At baseline cross-sectional multivariate analysis, increasing age, total cholesterol, current smoking and Alexithymia score≥50 were significantly associated with both increased cIMT (linear regression) and CPs (logistic regression). At follow-up analysis, log-rank tests and Cox's regression revealed that only older age (p = 0.001), current smoking (p = 0.019) and alexithymia score≥50 (p = 0.013) were independently associated with vascular events.<h4>Conclusions/significance</h4>In HIV-infected subjects, the Alexithymic trait emerges as a strong predictor of increased IMT, presence of CPs and vascular events. Such results are preliminary and require confirmation from studies with larger sample size and longer follow-up. |
| format |
article |
| author |
Giustino Parruti Francesco Vadini Federica Sozio Elena Mazzott Tamara Ursini Ennio Polill Paola Di Stefano Monica Tontodonati Maria C Verrocchio Maria C Verrocchio Mario Fulcheri Giulio Calella Francesca Santilli Lamberto Manzoli |
| author_facet |
Giustino Parruti Francesco Vadini Federica Sozio Elena Mazzott Tamara Ursini Ennio Polill Paola Di Stefano Monica Tontodonati Maria C Verrocchio Maria C Verrocchio Mario Fulcheri Giulio Calella Francesca Santilli Lamberto Manzoli |
| author_sort |
Giustino Parruti |
| title |
Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study. |
| title_short |
Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study. |
| title_full |
Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study. |
| title_fullStr |
Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study. |
| title_full_unstemmed |
Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study. |
| title_sort |
psychological factors, including alexithymia, in the prediction of cardiovascular risk in hiv infected patients: results of a cohort study. |
| publisher |
Public Library of Science (PLoS) |
| publishDate |
2013 |
| url |
https://doaj.org/article/8469d23a1ac941f1bb2171a91257ec1a |
| work_keys_str_mv |
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