P365 MANAGEMENT OF DYSLIPIDAEMIA AND CARDIOVASCULAR RISK REDUCTION IN HIV PATIENTS Free

At our dedicated cardiology outpatient clinic, patients with HIV infection are seen daily. This patient population undergoes routine haematochemical analyses including lipid assessment every six months.

Patients with HIV infection referred to the dedicated cardiology outpatient clinic in the period between March and September 2022 were retrospectively enrolled. For each of these patients, the medical history was collected and the global cardiovascular risk, lipid assessment (total cholesterol, LDL–C, HDL–C, triglycerides), hypolipidemic therapy (if any) and, in accordance with the most recent guidelines of the European Society of Cardiology, the achieved LDL target were assessed.

200 patients with mean age 59±15 years with HIV infection on antiretroviral treatment since 20±11 years, 92% male, were enrolled. 58% of patients had hypertension, 46% vasculopathy, 44% smoking, 14% diabetes, 10% chronic ischaemic heart disease and 4% previous stroke/TIA. Among these patients, 30% had a very high cardiovascular risk, 42% a high cardiovascular risk, 22% a moderate cardiovascular risk and 6% a low cardiovascular risk. Only 60% was on hypolipidemic therapy (statin in 50 per cent of cases and statin+ezetimibe in 10 per cent). Patients with a very high cardiovascular risk had an average LDL–cholesterol of 119.2±45.5 mg/dl, patients with a high cardiovascular risk 122.4±43.6 and only 12% of them was found to meet the guideline LDL targets.

Assessment and management of cardiovascular risk is crucial in order to reduce mortality and morbidity. In some particular clinical settings such as for patients with chronic infectious diseases (e.g. HIV) more attention must be paid to the LDL–cholesterol target in relation to the individual cardiovascular risk, which is often high or very high. Correct therapeutic management of dyslipidaemia through the use of the fixed statin/ezetimibe combination and the most innovative hypolipidemic therapies such as bempedoic acid, PCSK9 inhibitors, and inclisiran is the keystone in order to achieve the target.