{"doi":"10.21037/cdt.2019.12.02","title":"Cardiovascular risk and D-dimer levels in HIV-infected ART-naïve Africans","abstract":"Anti-retroviral therapy (ART) has decreased morbidity and mortality in HIV-infected individuals. With the adoption of the 90-90-90 strategy prevention and control of non-communicable disease, particularly knowledge of the burden and profile of cardiovascular disease, will become increasingly important. Our study assessed cardiovascular risk among recently diagnosed HIV-infected ART-naïve patients in a first referral urban hospital in a low-income country in sub-Saharan Africa. HIV-positive ART-naïve patients were submitted to cardiovascular risk assessment, clinical history, physical examination and laboratory workout, including 12-lead electrocardiography, portable transthoracic echocardiography, glycemia, lipidemia, hemogram and D-dimers. Three years after the diagnosis their vital status and occurrence of major cardiovascular events was assessed. We recruited 70 patients, all of black ethnicity (41 females; mean age 37±10.7). CD4 levels were very low (mean 21.3 cells/mL; SD 10.4). Twenty-one (26.6%) were overweight, 13 (16.7%) were obese, 19 (20.5%) had hyperglycemia and 20 patients (25.6%) had hypercholesterolemia. The median blood pressure was 119.5/79 mmHg (IQR 107-141/67-83); 20 patients (25.6%) had hypertension. Four (5.7%) patients had signs of heart failure, and left ventricular ejection fraction was reduced in 17 (25%). High levels of circulating D-dimers were found in 44 (62.8%) patients; the mean levels were 725.9 (SD 555.1). We found high occurrence of cardiovascular risk factors, left ventricular dysfunction and evidence of a pro-coagulant state in these HIV-infected ART-naïve patients. Active cardiovascular risk screening and stratification, as well as management protocols tailored to low-income settings are needed to sustain the gains obtained with increased availability of ART in Africa.","journal":"Cardiovascular Diagnosis and Therapy","year":2020,"id":74904,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9574,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":391228,"name":"Igor Dobe","orcid":"0000-0003-4256-7657","position":1,"is_corresponding":false},{"id":391875,"name":"Sandra Cândido","orcid":null,"position":2,"is_corresponding":false},{"id":391876,"name":"Nick Kim","orcid":null,"position":3,"is_corresponding":false},{"id":42821,"name":"Ana Olga Mocumbi","orcid":"0000-0002-9564-2860","position":0,"is_corresponding":true}],"reference_count":50,"raw_metadata":null,"created_at":"2026-07-18T21:46:11.663457Z","pmid":"32695632","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}