CAD in men with HIV linked to inflammatory biomarkers
Higher levels of inflammatory markers are associated with greater prevalence of coronary stenosis in men with HIV, researchers reported in the Journal of the American Heart Association.
“This study shows that even well-treated HIV patients have higher levels of inflammation compared with the general population and suggests that it may be the reason for increased heart disease in this population,” Hossein Bahrami, MD, PhD, MPH, assistant professor of cardiovascular medicine at the Keck School of Medicine of the University of Southern California, told Cardiology Today.
Using data from the MACS Cardiovascular Ancillary Study, Bahrami and colleagues investigated the relationship between inflammation and subclinical CAD in men with HIV (n = 575) and men not infected with HIV (n = 348). Outcomes of interest included presence and extent coronary artery calcification as measured by CT angiography, including characteristics of coronary plaques and degree of coronary stenosis.
Compared with men without HIV, men with HIV had higher levels of interleukin-6, intercellular adhesion molecule-1, C-reactive protein, and soluble-tumor necrosis factor-alpha receptor I and II (all P < .01) and a greater prevalence of noncalcified plaque (63% vs. 54%; P = .02) on CT angiography.
In addition, there was a 30% increase in prevalence of coronary stenosis of at least 50% for every standard deviation increase in log-interleukin and a 60% increase in prevalence of coronary stenosis of at least 50% for every standard deviation increase in log intercellular adhesion molecule-1 in men with HIV (all P < .05).
Bahrami and colleagues determined the following factors were associated with greater coronary stenosis prevalence in men with HIV: higher levels of interleukin-6, soluble-tumor necrosis factor-alpha receptor I and soluble-tumor necrosis factor-alpha receptor II.
“It is important to keep HIV infection in mind as a risk factor for coronary diseases when we are trying to identify high-risk populations. As the result, we need to take steps to treat other risk factors for coronary diseases more aggressively in this population,” Bahrami said. “Currently, we do not have treatments that are used specifically in HIV population. However, studies like this are important to lead future research in developing treatment strategies to specifically target this population.”
Bahrami also said that future studies will need to show the exact mechanisms that relate inflammation to increased risk for CAD. “Our team … is also doing another ongoing study using even more advanced MRI technology to evaluate other aspects of heart disease in HIV-infected populations and the role of inflammation in it,” he said. – by Tracey Romero
Disclosure: Bahrami reports no relevant financial disclosures. Other researchers report financial ties with Bristol-Myers Squibb, General Electric, Gilead Sciences, Janssen Pharmaceuticals, Merck and Verily Life Sciences.