Journal
RADIOLOGY
Volume 299, Issue 3, Pages 571-580Publisher
RADIOLOGICAL SOC NORTH AMERICA (RSNA)
DOI: 10.1148/radiol.2021203297
Keywords
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Funding
- Canadian Institutes of Health Research [284512, 398643]
- National Institutes of Health [R01AG054324]
- RBIQ-FRSQ 9e Concours 2013 project [9.04]
- Network SIDA-MI (FRQS)
- FRQS operating grant [35381]
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This study found that asymptomatic people living with HIV have a higher burden of noncalcified coronary plaque and a lower frequency of calcified plaque compared to healthy volunteers.
Background: People living with HIV (PLWH) have a higher risk of myocardial infarction. Coronary atherosclerotic plaque CT characterization helps to predict cardiovascular risk. Purpose: To measure CT characteristics of coronary plaque in PLWH without known cardiovascular disease and healthy volunteers without HIV. Materials and Methods: In this prospective study, noncontrast CT (all participants, n = 265) was used for coronary artery calcium (CAC) scoring in asymptomatic PLWH and healthy volunteers without HIV, without known cardiovascular disease, from 2012 to 2019. At coronary CT angiography (n = 233), prevalence, frequency, and volume of calcified, mixed, and noncalcified plaque were measured. Poisson regressions were used with adjustment for cardiovascular risk factors. Results: There were 181 PLWH (mean age, 56 years 6 7; 167 men) and 84 healthy volunteers (mean age, 57 years 6 8; 65 men) evaluated by using noncontrast CT. CT angiography was performed in 155 PLWH and 78 healthy volunteers. Median 10-year Framingham risk score was not different between PLWH and healthy volunteers (10% vs 9%, respectively; P=.45), as were CAC score (odds ratio [OR], 1.06; 95% CI: 0.58, 1.94; P=.85) and overall plaque prevalence (prevalence ratio, 1.07; 95% CI: 0.86, 1.32; P=.55) after adjustment for cardiovascular risk. Noncalcified plaque prevalence (prevalence ratio, 2.5; 95% CI: 1.07, 5.67; P=.03) and volume (OR, 2.8; 95% CI: 1.05, 7.40; P=.04) were higher in PLWH. Calcified plaque frequency was reduced in PLWH (OR, 0.6; 95% CI: 0.40, 0.91; P=.02). Treatment with protease inhibitors was associated with higher volume of overall (OR, 1.8; 95% CI: 1.09, 2.85; P=.02) and mixed plaque (OR, 1.6; 95% CI: 1.04, 2.45; P=.03). Conclusion: Noncalcified coronary plaque burden at coronary CT angiography was two- to threefold higher in asymptomatic people living with HIV without known cardiovascular disease compared with healthy volunteers without HIV. (C) RSNA, 2021
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