Coronary Plaque in People With HIV vs Non-HIV Asymptomatic Community and Symptomatic Higher-Risk Populations
Year: 2024
Type: article
Abstract: People with HIV (PWH) have a high burden of coronary plaques; however, the comparison to people without known HIV (PwoH) needs clarification. The purpose of this study was to determine coronary plaque burden/phenotype in PWH vs PwoH. Nonstatin using participants from 3 contemporary populations without known coronary plaques with coronary CT were compared: the REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) studying PWH without cardiovascular symptoms at low-to-moderate risk (n = 755); the SCAPIS (Swedish Cardiopulmonary Bioimage Study) of asymptomatic community PwoH at low-to-intermediate cardiovascular risk (n = 23,558); and the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) of stable chest pain PwoH (n = 2,291). The coronary plaque prevalence on coronary CT was compared, and comparisons were stratified by 10-year atherosclerotic cardiovascular disease (ASCVD) risk, age, and coronary artery calcium (CAC) presence. Compared to SCAPIS and PROMISE PwoH, REPRIEVE PWH were younger (50.8 ± 5.8 vs 57.3 ± 4.3 and 60.0 ± 8.0 years; P < 0.001) and had lower ASCVD risk (5.0% ± 3.2% vs 6.0% ± 5.3% and 13.5% ± 11.0%; P < 0.001). More PWH had plaque compared to the asymptomatic cohort (48.5% vs 40.3%; P < 0.001). When stratified by ASCVD risk, PWH had more plaque compared to SCAPIS and a similar prevalence of plaque compared to PROMISE. CAC = 0 was more prevalent in PWH (REPRIEVE 65.2%; SCAPIS 61.6%; PROMISE 49.6%); among CAC = 0, plaque was more prevalent in PWH compared to the PwoH cohorts (REPRIEVE 20.8%; SCAPIS 5.4%; PROMISE 12.3%, P < 0.001). Asymptomatic PWH in REPRIEVE had more plaque than asymptomatic PwoH in SCAPIS but had similar prevalence to a higher-risk stable chest pain cohort in PROMISE. In PWH, CAC = 0 does not reliably exclude plaque.
Source: JACC Advances
Authors: Julia Karady, Michael T. Lu, Göran Bergström, Thomas Mayrhofer, Jana Taron, Borek Foldyna, Kayla Paradis, Sara McCallum, Judith A. Aberg, Judith S. Currier, Kathleen V. Fitch, Evelynne S. Fulda, Gerald S. Bloomfield, Edgar T. Overton, Lars Lind, Carl Johan Östgren, Olof Elvstam, Stefan Söderberg, Tomas Jernberg, Rosalie Pepe, Michael P. Dubé, David Mushatt, Carl J. Fichtenbaum, Carlos Malvestutto, Markella V. Zanni, Udo Hoffmann, Heather Ribaudo, Steven K. Grinspoon, Pamela S. Douglas
Institutions: Semmelweis University, Harvard University, Massachusetts General Hospital, Sahlgrenska University Hospital, Region Västra Götaland, University of Gothenburg, University of Applied Sciences Stralsund, University of Freiburg, University Medical Center Freiburg, Icahn School of Medicine at Mount Sinai, University of California, Los Angeles, Duke University, University of Alabama at Birmingham, Uppsala University, Linköping University, Lund University, Växjö Kommun, Umeå University, Danderyds sjukhus, Karolinska Institutet, Cooper University Hospital, University of Southern California, Tulane University, University of Cincinnati, The Ohio State University Wexner Medical Center
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,850
OpenAlex ID: W4396631772