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AIDS. 2019 May 1;33(6):1053-1061. doi: 10.1097/QAD.0000000000002151.

Associations between lipids and subclinical coronary atherosclerosis.

Author information

1
Division of Cardiology, Department of Medicine, Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine.
2
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health.
3
MedStar Health System.
4
Division of Endocrinology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
5
Division of Infectious Diseases, Feinberg School of Medicine of Northwestern University, Chicago, Illinois.
6
Department of Infectious Diseases and Microbiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
7
Department of Medicine, Harbor UCLA, Los Angeles.
8
Division of HIV Medicine, Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, Torrance, California, USA.

Abstract

OBJECTIVE:

Whether HIV modifies the relationship of serum lipids with coronary atherosclerosis and coronary plaque subtypes is uncertain. We examined the associations between traditional lipids and coronary atherosclerosis among HIV-infected (HIV+) and HIV-uninfected (HIV-) men.

DESIGN:

The Multicenter AIDS Cohort Study is an observational cohort with a total of 429 HIV+ and 303 HIV- men who had non-contrast cardiac computed tomography performed to measure coronary artery calcium and coronary computed tomography angiography to measure coronary stenosis, coronary plaque presence, and composition.

METHODS:

We used multivariable adjusted prevalence ratios to examine the relationship between the SD difference in each lipid parameter and coronary atherosclerosis.

RESULTS:

Total cholesterol (TC)/HDL-cholesterol had the strongest associations with coronary atherosclerosis regardless of HIV status. Overall, lipid parameters were most strongly associated with the presence of mixed plaque, stenosis more than 50%, and coronary artery calcium for both HIV+ and HIV- men. HIV+ men had similar, but weaker associations, between lipid parameters and coronary atherosclerosis compared with HIV- men. The strongest association was between the TC/HDL-cholesterol and stenosis more than 50% for both HIV+ [prevalence ratios 1.25 per SD (95% confidence interval 1.07-1.43)] and HIV- men [prevalence ratios 1.46 per SD (95% confidence interval 1.08-1.85)].

CONCLUSION:

The associations between lipids and coronary atherosclerosis tended to be weaker for HIV+ compared with HIV- men, although TC/HDL had the strongest association for both HIV+ and HIV- men. A weaker association between lipid levels and coronary atherosclerosis for HIV+ men may contribute to the decreased discrimination of cardiovascular disease risk observed in HIV+ individuals.

PMID:
30946159
PMCID:
PMC6457132
[Available on 2020-05-01]
DOI:
10.1097/QAD.0000000000002151

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