Increased arterial inflammation relates to high-risk coronary plaque morphology in HIV-infected patients

Ahmed Tawakol, Janet Lo, Markella V. Zanni, Eleni Marmarelis, Ezinne J. Ihenachor, Megan MacNabb, Bryan Wai, Udo Hoffmann, Suhny Abbara, Steven Grinspoon

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

Background: Mechanisms predisposing HIV-infected patients to increased cardiovascular disease (CVD) risk remain unclear. Objective: To determine the interrelationship between arterial inflammation and high-risk coronary plaque morphology in HIV-infected patients with subclinical coronary atherosclerosis. Methods: Forty-one HIV-infected patients on stable antiretroviral therapy without known CVD but with atherosclerotic plaque on coronary CT angiography were evaluated with 18F-FDG-PET. Patients were stratified into 2 groups based on relative degree of arterial inflammation [aortic target-to-background ratio (TBR)]. High-risk coronary atherosclerotic plaque morphology features were compared between groups. Results: HIV-infected patients with higher and lower TBRs were similar with respect to traditional CVD risk parameters. Among HIV-infected patients with higher TBR, an increased percentage of patients demonstrated at least 1 low-attenuation coronary atherosclerotic plaque (40% vs. 10%, P = 0.02) and at least 1 coronary atherosclerotic plaque with both low attenuation and positive remodeling (35% vs. 10%, P = 0.04). Moreover, in the higher TBR group, both the number of low-attenuation plaques per patient (P = 0.02) and the number of vulnerability features in the most vulnerable plaque (P = 0.02) were increased. TBR grouping remained significantly related to the number of low-attenuation plaques/subject (β = 0.35, P = 0.004), controlling for age, gender, low-density lipoprotein, duration of HIV, and CD4. Conclusions: These data demonstrate a relationship between arterial inflammation on 18F-FDG-PET and high-risk coronary atherosclerotic plaque features among HIV-infected patients with subclinical coronary atherosclerosis. Further studies are needed to determine whether arterial inflammation and related high-risk coronary morphology increase the risk of clinical CVD events in the HIV population.

Original languageEnglish (US)
Pages (from-to)164-171
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume66
Issue number2
DOIs
StatePublished - Jun 1 2014

Keywords

  • HIV
  • arterial inflammation
  • cardiovascular disease
  • coronary atherosclerotic plaque

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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    Tawakol, A., Lo, J., Zanni, M. V., Marmarelis, E., Ihenachor, E. J., MacNabb, M., Wai, B., Hoffmann, U., Abbara, S., & Grinspoon, S. (2014). Increased arterial inflammation relates to high-risk coronary plaque morphology in HIV-infected patients. Journal of Acquired Immune Deficiency Syndromes, 66(2), 164-171. https://doi.org/10.1097/QAI.0000000000000138