Rationale and design of the Mechanistic Substudy of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE): Effects of pitavastatin on coronary artery disease and inflammatory biomarkers

Assessment of Coronary Artery Disease With Computed Tomography Angiography and Inflammatory and Immune Activation Biomarkers Among Adults With HIV Eligible for Primary Cardiovascular Prevention

“… 15 The mechanistic substudy was designed to simultaneously assess plaque by coronary computed tomography angiography (CTA) and critical pathways of arterial inflammation and immune activation. 16 In this baseline analysis, our primary objective was to assess the prevalence and composition of CAD, with a focus on the presence of plaque as our main CAD end point. Our secondary objective was to assess immune activation and inflammatory indices in association with plaque.…”

Effect of vessel wall segmentation on volumetric and radiomic parameters of coronary plaques with adverse characteristics

“…While this might seem as a selection bias which potentially decreases reproducibility, it is these plaques at are potential targets of new therapies and are interests of many quantitative research analyses. 6,7 However, it seems, that even among readers with considerable experience, there is substantial variation in contouring which leads to differences in plaque volumes. Unfortunately, this difference is largest in case of low-attenuation noncalcified plaque volume, which is currently of major research interest as it correlates with multiple clinical outcomes, [1][2][3][4][5] and therefore is seen as a potential pharmaceutical target.…”

“…Unfortunately, this difference is largest in case of low-attenuation noncalcified plaque volume, which is currently of major research interest as it correlates with multiple clinical outcomes, [1][2][3][4][5] and therefore is seen as a potential pharmaceutical target. 6,7 Radiomic analysis is a promising new technique which may have the potential to increase the diagnostic accuracy of coronary CTA to identify vulnerable. 28,34 Furthermore, it may also increase the capabilities of CT imaging by identifying plaques showing positivity on positron emission tomography without the need of radionuclide tracers.…”

“…[1][2][3][4][5] New drug trials have even defined changes in CT angiography (CTA) derived plaques volumes as surrogate clinical end-points to test the efficacy of novel lipid lowering therapies. 6,7 Atherosclerotic lesions with adverse plaque characteristics (APC) are major targets of novel therapies, as these have been shown to greatly increase the risk of future adverse cardiac events. 8,9 Also, radiomics has emerged as a novel image processing technique which may allow the precision phenotyping of diseases based on radiological images.…”

Non-linear optical imaging of atherosclerotic plaques in the context of SIV and HIV infection prominently detects crystalline cholesterol esters

“…1.2 million people live in the US with HIV, while globally 35 million are infected, with 2 million new infections a year (US CDC.Gov). Hence, the finding that HIV infection may accelerate atherosclerosis has impact on the vascular complications management in this large and now long-lived cohort of individuals [ 16 , 17 ]. Moreover, mechanistic understanding of how viremia accelerates atherosclerosis is of significant interest since recent evidence has shown that dysregulation of the innate immune system also drives plaque progression and CVD events.…”