Introduction: HIV infection is one of the chronic diseases with a markedly improved survival rate. Increasing age in HIV patients, along with lipid abnormalities have been associated with higher risk of coronary artery disease.
Hypothesis: We sought to evaluate plaque characteristics in HIV patients with coronary ectasia to identify if they differ from cohorts without HIV and ectasia.
Methods: We evaluated plaque characteristics in 198 asymptomatic men chosen from Multicenter AIDS Cohort Study. All patients underwent coronary computed tomography angiography in 2010 and again in 2015. To analyze plaque characteristics, we used Q angio software version of 18.104.22.168 (Medis, Netherlands). We used t- test to compare groups and multivariable linear logistic regression to control for traditional risk factors.
Results: HIV positive patients with ectasia showed more soft plaques including fibrous, fibrous fatty and low attenuation plaques than those without HIV and ectasia (Table 1). Total plaque burden was higher in patients with HIV and ectasia compared to individuals without these (β 7.2, CI 4.0, 10.5, p<0.001). The strongest predictors in patients with HIV and ectasia was low attenuation plaque, fibrous plaque, and fibrous fatty plaque (all p<0.001). Calcified plaques was not as strong other plaque types. Traditional cardiovascular risk factors didn’t modify any relationships between ectasia and plaque.
Conclusion: Non-calcified plaques is one of the influential factors in the process of cardiovascular disease in HIV positive patients who had ectasia. Outcome data in this cohort is warranted.
Table 1. Adjusted Association Between Ectasia and Coronary Artery Plaque Volume (Multivariate Regression Analysis) ¶: ξ Adjusted model, and the plaque volume was present by mean±SD
¶ Model adjusted for age, race, BMI, LDL, HDL, hypertension, hyperlipidemia, diabetes, smoking, drinking, family history of heart attack.