Observational studyJournal of the American Heart Association2025
Baseline ECG and Cardiovascular Outcomes in People With HIV: Insights From REPRIEVE.
Observational study in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Authors and funding
21 authors.
Funding
Abstract
backgroundWith antiretroviral therapy, people with HIV (PWH) have an increased burden of cardiovascular disease. The REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) trial demonstrated that pitavastatin reduces major adverse cardiovascular events (MACEs) among PWH at low to moderate traditional atherosclerotic risk. Electrocardiographic abnormalities are common in PWH, but little is known about their association with MACEs. We sought to examine whether baseline electrocardiographic abnormalities are associated with increased MACE risk among a global primary cardiovascular disease prevention cohort of PWH in REPRIEVE.
methodsIn this observational analysis, entry electrocardiographic abnormalities were adjudicated and classified as major or minor abnormalities. Multivariable cause-specific Cox proportional hazards models assessed the association of electrocardiographic abnormalities with MACEs while stratifying for treatment effect. The model improvement with the addition of the ECG to a model with the pooled cohort equations risk score was examined.
resultsAmong 7719 participants (median age, 50 years; 69% men), 49% had ≥1 electrocardiographic abnormality, with 3% classified as major. Over a median of 5.6 years, a major electrocardiographic abnormality was associated with a 2.42-fold (95% CI, 1.49-3.91) higher hazard of incident MACEs, whereas minor abnormalities were not. Specific abnormalities associated with MACEs were chamber enlargement and infarct/ischemia pattern. No significant subgroup- or treatment-related interaction was observed. Adding electrocardiographic findings to traditional risk factors increased the C-statistic modestly (+0.01).
conclusionsAmong PWH in REPRIEVE, electrocardiographic abnormalities were common, but major electrocardiographic abnormalities were rare. Though major abnormalities were associated with increased hazard of MACEs, routine electrocardiographic screening is unlikely to improve the prediction of future cardiovascular events in this primary prevention population with low to moderate cardiovascular risk.
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