To evaluate the efficacy of pitavastatin in reducing major adverse cardiovascular events (MACE) in HIV-positive individuals with moderate to low cardiovascular risk, highlighting its relevance to current treatment guidelines.
Key Findings:
Pitavastatin reduced MACE by 35% compared to placebo (4.81 vs. 7.32 events per 1,000 person-years; HR 0.65, p = 0.002). Individual components of MACE were numerically lower in the pitavastatin group, but statistical significance for these comparisons was not established.
Interpretation:
The findings support the use of pitavastatin for primary cardiovascular disease prevention in HIV-positive individuals, particularly those with moderate to low risk factors.
Limitations:
The trial was not powered for individual MACE component comparisons. Few older adults were enrolled, limiting generalizability to this age group. Traditional risk calculators may underestimate ASCVD risk in PLWH, which is critical for understanding the study's applicability.
Conclusion:
Pitavastatin is effective in reducing cardiovascular risk in HIV-positive individuals with moderate to low risk factors, supporting updated guidelines for statin use in this population, particularly for primary prevention.
