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Association of Cardiac Troponin T With Coronary Atherosclerosis in Asymptomatic Primary Prevention People With HIV.

Publication ,  Journal Article
deFilippi, C; McCallum, S; Zanni, MV; Fitch, KV; Diggs, MR; Bloomfield, GS; Fichtenbaum, CJ; Aberg, JA; Malvestutto, CD; Pinto-Martinez, A ...
Published in: JACC Adv
September 2024

BACKGROUND: Coronary plaque is common among people with HIV (PWH) with low-to-moderate traditional atherosclerotic cardiovascular disease (ASCVD) risk. OBJECTIVES: The purpose of this study was to determine the association of high-sensitivity cardiac troponin T (hs-cTnT) levels with coronary plaque characteristics and evaluate if hs-cTnT improves identification of these features beyond traditional ASCVD risk factors among PWH. METHODS: Among PWH receiving stable antiretroviral therapy with low-to-moderate ASCVD risk and no known history of ASCVD, hs-cTnT levels and measures of plaque by coronary computed tomography angiography were assessed. Primary outcomes included the association of hs-cTnT level with the presence of any plaque, vulnerable plaque, coronary artery calcium (CAC) score, and Leaman score. Assessment of model discrimination of hs-cTnT for plaque characteristics was also performed. RESULTS: The cohort included 708 U.S. participants with a mean age of 51 ± 6 years, 119 (17%) females, a median ASCVD risk score of 4.4% (Q1-Q3: 2.5%-6.6%), and a median hs-cTnT level of 6.7 ng/L (detectable level ≥6 ng/L in 61%). Any plaque was present in 341 (48%), vulnerable plaque in 155 (22%), CAC>100 in 68 (10%), and a Leaman score >5 in 105 (15%). After adjustment for ASCVD risk score, participants with hs-cTnT >9.6 ng/L (highest category) versus an undetectable level (<6 ng/L) had a greater relative risk for any plaque (1.37, 95% CI: 1.12-1.67), vulnerable plaque (1.47, 95% CI: 1.16-1.87), CAC>100 (2.58, 95% CI: 1.37-4.83), and Leaman score >5 (2.13, 95% CI: 1.32-3.46). The addition of hs-cTnT level modestly improved the discrimination of ASCVD risk score to identify critical plaque features. CONCLUSIONS: In PWH without known ASCVD, hs-cTnT levels were strongly associated with and improved prediction of subclinical coronary plaque. (Evaluating the Use of Pitavastatin to Reduce the Risk of Cardiovascular Disease in HIV-Infected Adults [REPRIEVE]; NCT02344290).

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Published In

JACC Adv

DOI

EISSN

2772-963X

Publication Date

September 2024

Volume

3

Issue

9

Start / End Page

101206

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
deFilippi, C., McCallum, S., Zanni, M. V., Fitch, K. V., Diggs, M. R., Bloomfield, G. S., … Grinspoon, S. K. (2024). Association of Cardiac Troponin T With Coronary Atherosclerosis in Asymptomatic Primary Prevention People With HIV. JACC Adv, 3(9), 101206. https://doi.org/10.1016/j.jacadv.2024.101206
deFilippi, Christopher, Sara McCallum, Markella V. Zanni, Kathleen V. Fitch, Marissa R. Diggs, Gerald S. Bloomfield, Carl J. Fichtenbaum, et al. “Association of Cardiac Troponin T With Coronary Atherosclerosis in Asymptomatic Primary Prevention People With HIV.JACC Adv 3, no. 9 (September 2024): 101206. https://doi.org/10.1016/j.jacadv.2024.101206.
deFilippi C, McCallum S, Zanni MV, Fitch KV, Diggs MR, Bloomfield GS, et al. Association of Cardiac Troponin T With Coronary Atherosclerosis in Asymptomatic Primary Prevention People With HIV. JACC Adv. 2024 Sep;3(9):101206.
deFilippi, Christopher, et al. “Association of Cardiac Troponin T With Coronary Atherosclerosis in Asymptomatic Primary Prevention People With HIV.JACC Adv, vol. 3, no. 9, Sept. 2024, p. 101206. Pubmed, doi:10.1016/j.jacadv.2024.101206.
deFilippi C, McCallum S, Zanni MV, Fitch KV, Diggs MR, Bloomfield GS, Fichtenbaum CJ, Aberg JA, Malvestutto CD, Pinto-Martinez A, Stapleton A, Duggan J, Robbins GK, Taron J, Karady J, Foldyna B, Lu MT, Ribaudo HJ, Douglas PS, Grinspoon SK. Association of Cardiac Troponin T With Coronary Atherosclerosis in Asymptomatic Primary Prevention People With HIV. JACC Adv. 2024 Sep;3(9):101206.

Published In

JACC Adv

DOI

EISSN

2772-963X

Publication Date

September 2024

Volume

3

Issue

9

Start / End Page

101206

Location

United States