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. 2024 Aug;37(4):341-350.
doi: 10.37201/req/033.2024. Epub 2024 Apr 29.

Progression of subclinical cardiovascular disease in patients with HIV

M Fayos, F Arnaiz de Las Revillas, V González Quintanilla, C González-Rico, C Fariñas-Álvarez, J A Parra, M C Fariñas  1
Affiliations

Progression of subclinical cardiovascular disease in patients with HIV

M Fayos et al. Rev Esp Quimioter. 2024 Aug.

Abstract
in English, Spanish

Objective: Human immunodeficiency virus (HIV) infected patients are at increased risk of cardiovascular disease (CVD). Multidetector computed tomography (MDCT) stratifies cardiovascular risk in asymptomatic patients with subclinical atherosclerosis. The aim of this study was to determine the ability of MCTD and clinical and laboratory parameters to assess subclinical CVD progression in HIV patients.

Methods: Prospective longitudinal cohort study of patients with at least 10 years of HIV infection and 5 years of antiretroviral therapy history, low cardiovascular risk and monitored for 6 years (2015-2021). All patients underwent clinical assessment, blood analysis, carotid ultrasound, and gated MDCT in 2015 and 2021.

Results: Sixty-three patients (63.5% male) with a mean age of 49.9 years (standard deviation [SD], 10.5) were included in 2015; 63 of them were followed until 2021. Comparing the results from 2015 with those from 2021, Systematic Coronary Risk Estimation-2 (SCORE2) was 2.9% (SD, 2.1) vs. 4.4% (SD,3.1); Multi-Ethnic Study of Atherosclerosis score (MESA risk) was 3.4 (SD 5.8) vs. 6.0 (SD 8.6); coronary artery calcification CAC) score >100 was 11.1% vs. 25.4% (P < 0.05); and 11% vs. 27% had carotid plaques (P = 0.03).

Conclusions: After six years of follow-up, an increase in SCORE2, carotid plaques, CAC scoring and MESA risk was observed. MDCT findings, along with other clinical and laboratory parameters, could play an important role as a marker of CVD progression in the evaluation of patients with HIV and low cardiovascular risk.

Introducción: Los pacientes infectados por el virus de la inmunodeficiencia humana (VIH) tienen mayor riesgo de enfermedades cardiovasculares (ECV). La tomografía computarizada multidetector (TCMD) estratifica el riesgo cardiovascular en pacientes asintomáticos con aterosclerosis subclínica. El objetivo del estudio fue determinar la capacidad de la MCTD y los parámetros clínicos y de laboratorio para evaluar la progresión subclínica de la ECV en pacientes con VIH.

Material y métodos: Estudio de cohorte longitudinal prospectivo de pacientes con al menos 10 años de infección por VIH, 5 años de tratamiento, bajo riesgo cardiovascular y seguimiento durante 6 años (2015-2021). Se realizó evaluación clínica, análisis de sangre, ecografía carotídea y TCMD en 2015 y 2021.

Resultados: En 2015 se incluyeron 63 pacientes (63,5% varones) con una edad media de 49,9 años (desviación estándar [DE], 10,5); y fueron seguidos hasta 2021. Comparando los resultados de 2015 y 2021, la Estimación Sistemática de Riesgo Coronario-2 (SCORE2) fue del 2,9% (DE, 2,1) vs. 4,4% (DE, 3,1); La puntuación del Estudio Multiétnico de Aterosclerosis (riesgo MESA) fue de 3,4 (DE 5,8) vs. 6,0 (DE 8,6); el score de calcificación de la arteria coronaria (CAC) >100 fue del 11,1% vs. 25,4% (P < 0,05); y el 11% vs. 27% tenían placas carotídeas (P = 0,03).

Conclusiones: Después de seis años de seguimiento, se ha observado un aumento en SCORE2, placas carotídeas, CAC y MESA. El TCMD, junto con otros parámetros clínicos y de laboratorio, podría desempeñar un papel importante como marcador de progresión de ECV en la evaluación de pacientes con VIH y bajo riesgo cardiovascular.

Keywords: HIV; coronary calcium score; intima media thickness; multidetector computed tomography; subclinical cardiovascular disease.

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Conflict of interest statement

Authors declare no conflict of interest

Figures

Figure 1
Figure 1
Inclusion criteria algorithm. Legends: HIV: human immunodeficiency virus. ART: antiretroviral therapy. IC: informed consent. MDCT: multidetector computed tomography. CIMT: carotid intima-media thickness test.
See this image and copyright information in PMC

References

    1. Panel of Experts from the Metabolic D, Comorbilities Study G, Aids Study G, National Aids Plan . Electronic address rme. Executive summary of the consensus document on metabolic disorders and cardiovascular risk in patients with HIV infection. Enferm Infecc Microbiol Clin (Engl Ed). 2019;37(1):50-55. 10.1016/j.eimc.2017.06.007 - DOI - PubMed
    1. Raposeiras-Roubin S, Triant V. Ischemic Heart Disease in HIV: An In-depth Look at Cardiovascular Risk. Rev Esp Cardiol (Engl Ed). 2016;69(12):1204-1213. 10.1016/j.rec.2016.10.005 - DOI - PubMed
    1. Hsue PY, Waters DD. Time to Recognize HIV Infection as a Major Cardiovascular Risk Factor. Circulation. 2018;138(11):1113-1115. 10.1161/CIRCULATIONAHA.118.036211 - DOI - PMC - PubMed
    1. Mostaza JM, Pinto X, Armario P, Masana L, Ascaso JF, Valdivielso. et al. . Standards for global cardiovascular risk management arteriosclerosis. Clin Investig Arterioscler. 2019;31 Suppl 1:1-43. 10.1016/j.arteri.2019.03.004 - DOI - PubMed
    1. Dawber TR, Moore FE, Mann GV. Coronary heart disease in the Framingham study. Am J Public Health Nations Health. 1957;47(4 Pt 2):4-24. 10.2105/ajph.47.4_pt_2.4 - DOI - PMC - PubMed