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Ideal cardiovascular health, biomarkers, and coronary artery disease in persons with HIV.

Publication ,  Journal Article
Douglas, PS; McCallum, S; Lu, MT; Umbleja, T; Fitch, KV; Foldyna, B; Zanni, MV; Fulda, ES; Bloomfield, GS; Fichtenbaum, CJ; Overton, ET ...
Published in: AIDS
March 1, 2023

OBJECTIVE: To investigate relationships between Life's Simple 7 (LS7), an assessment of cardiovascular health (CVH), and coronary plaque among people with HIV (PWH). DESIGN: Cross-sectional. METHODS: Coronary computed tomography angiography, immune/inflammatory biomarkers, and characterization of LS7 were collected among a subset of ART-treated PWH enrolled in REPRIEVE, a primary prevention trial. Analyses adjusted for cardiovascular disease risk (ASCVD score). RESULTS: Median age of the 735 participants was 51(±6) years, 16% female, and median (Q1-Q3) CVD risk was 4.5% (2.6-6.9). Forty percent had poor (≤2 ideal components), 51% had intermediate (three or four ideal components), and only 9% had ideal CVH (≥5). Coronary plaque was present in 357 (49%); 167 (23%) had one or more vulnerable plaque features, 293 (40%) had noncalcified plaque, and 242 (35%) had a coronary artery calcium score >0. All three phenotypes were increasingly more prevalent with poorer CVH and these relationships remained after adjusting for ASCVD risk. Poor CVH was associated with higher high-sensitivity C-reactive protein, oxidized low-density cholesterol, and interleukin-6. The relationship of LS7 to plaque remained after adjusting for these biomarkers. CONCLUSIONS: Among PWH, poor CVH as measured by LS7 was associated with coronary plaque presence, vulnerable features, and calcification. LS7 was also associated with selected biomarkers; adjustment for these and ASCVD score reduced but did not eliminate LS7's association with plaque, suggesting the possibility of additional protective mechanisms against atherogenesis and plaque remodeling. Clinical use of LS7 and further exploration of its relationships with coronary artery disease may enhance efforts to reduce cardiovascular morbidity and mortality in PWH. CLINICAL TRIALS REGISTRATION: NCT02344290.

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Published In

AIDS

DOI

EISSN

1473-5571

Publication Date

March 1, 2023

Volume

37

Issue

3

Start / End Page

423 / 434

Location

England

Related Subject Headings

  • Virology
  • Risk Factors
  • Plaque, Atherosclerotic
  • Male
  • Humans
  • HIV Infections
  • Female
  • Cross-Sectional Studies
  • Coronary Artery Disease
  • Cardiovascular Diseases
 

Citation

APA
Chicago
ICMJE
MLA
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Douglas, P. S., McCallum, S., Lu, M. T., Umbleja, T., Fitch, K. V., Foldyna, B., … Grinspoon, S. K. (2023). Ideal cardiovascular health, biomarkers, and coronary artery disease in persons with HIV. AIDS, 37(3), 423–434. https://doi.org/10.1097/QAD.0000000000003418
Douglas, Pamela S., Sara McCallum, Michael T. Lu, Triin Umbleja, Kathleen V. Fitch, Borek Foldyna, Markella V. Zanni, et al. “Ideal cardiovascular health, biomarkers, and coronary artery disease in persons with HIV.AIDS 37, no. 3 (March 1, 2023): 423–34. https://doi.org/10.1097/QAD.0000000000003418.
Douglas PS, McCallum S, Lu MT, Umbleja T, Fitch KV, Foldyna B, et al. Ideal cardiovascular health, biomarkers, and coronary artery disease in persons with HIV. AIDS. 2023 Mar 1;37(3):423–34.
Douglas, Pamela S., et al. “Ideal cardiovascular health, biomarkers, and coronary artery disease in persons with HIV.AIDS, vol. 37, no. 3, Mar. 2023, pp. 423–34. Pubmed, doi:10.1097/QAD.0000000000003418.
Douglas PS, McCallum S, Lu MT, Umbleja T, Fitch KV, Foldyna B, Zanni MV, Fulda ES, Bloomfield GS, Fichtenbaum CJ, Overton ET, Aberg JA, Malvestutto CD, Burdo TH, Arduino RC, Ho KS, Yin MT, Ribaudo HJ, Grinspoon SK. Ideal cardiovascular health, biomarkers, and coronary artery disease in persons with HIV. AIDS. 2023 Mar 1;37(3):423–434.

Published In

AIDS

DOI

EISSN

1473-5571

Publication Date

March 1, 2023

Volume

37

Issue

3

Start / End Page

423 / 434

Location

England

Related Subject Headings

  • Virology
  • Risk Factors
  • Plaque, Atherosclerotic
  • Male
  • Humans
  • HIV Infections
  • Female
  • Cross-Sectional Studies
  • Coronary Artery Disease
  • Cardiovascular Diseases