Subclinical Atherosclerosis Imaging in People Living with HIV

Schoepf, Isabella C; Buechel, Ronny R.; Kovari, Helen; Hammoud, Dima A.; Tarr, Philip E.

doi:10.3390/jcm8081125

Cited by 9 publications

(6 citation statements)

References 175 publications

(274 reference statements)

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“…The degree of carotid atherosclerosis can indirectly reflect atherosclerosis in coronary arteries, cerebral arteries, and other parts of the body. 5,6 Meanwhile, carotid intima-media thickness (CIMT), which can be considered as a surrogate marker of subclinical carotid atherosclerosis (SCA) and an estimable index of the future occurrence of adverse vascular events in the high-risk population, is widely used in PLWH. 7–9…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk of subclinical carotid atherosclerosis in the global population with HIV: a systematic review and meta-analysis

Sun

Zhan

et al. 2021

Int J STD AIDS

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The current evidence regarding the prevalence of subclinical carotid atherosclerosis (SCA) for people living with HIV(PLWH) is inconsistent. In this study, we aimed to synthesize data on the prevalence and association of SCA patients with HIV infection. We searched PubMed, EMBASE, Web of Science, Medline, SinoMed, and CNKI from inception to March 2, 2020. The pooled proportion, odds ratio (OR) with 95% confidence intervals (CIs) were calculated. For inclusion, SCA was measured by carotid intima-media thickness (CIMT), with a B-mode ultrasound machine. Twenty-six studies consisting of 6590 participants were identified. The overall prevalence of SCA was 31.6% (95% CI 13.4‐53.3; I2 = 99%; 4 studies) according to CIMT ≥ 0.78 mm criteria, and 32.3% (19.6‐46.4; 97%; 10 studies) according to CIMT ≥ 0.90 mm criteria. SCA prevalence was higher in Europe, over 40 years old and male. What’s more, PLWH have a higher likelihood of developing SCA comorbidity than HIV-negative controls (pooled OR 2.66, 95% CI 1.57‐4.50, I2 = 74%; 9 studies), even after sensitivity analysis (pooled OR 2.58, 1.54‐4.31, 73%). This study suggests a high prevalence and risk of SCA in the global population with HIV. As a result, subclinical carotid atherosclerosis deserves more attention from policymakers, HIV health-care providers, researchers, and stakeholders.

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Section: Introductionmentioning

confidence: 99%

Prevalence and risk of subclinical carotid atherosclerosis in the global population with HIV: a systematic review and meta-analysis

Sun

Zhan

et al. 2021

Int J STD AIDS

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“…It also has the characteristics of high radiation and insufficient sensitivity to the detection of micro-calcification. [ 11 ]…”

Section: Introductionmentioning

confidence: 99%

“…Computed tomography can quantify calcification, which is the main method for CAC detection. It also has the characteristics of high radiation and insufficient sensitivity to the detection of micro-calcification [11] …”

Section: Introductionmentioning

confidence: 99%

“…It also has the characteristics of high radiation and insufficient sensitivity to the detection of micro-calcification. [11] Cystatin C (CysC), a lysosomal cysteine protease inhibitor, is widely expressed in all nucleated cells and most organs, with a constant production rate and distributed in all human body fluids. CysC is located on chromosome 20 and consists of about 120 amino acid residues with a molecular weight of 13.3 KD.…”

Section: Introductionmentioning

confidence: 99%

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Association of cystatin C with coronary artery calcification in patients undergoing multidetector computed tomography

Xiong¹,

Wang²,

Jin³

et al. 2021

Medicine

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Cystatin C is associated with atherosclerosis, but the relationship between cystatin C and coronary artery calcification (CAC) is uncertain. The purpose of this study was to evaluate the predictive value of cystatin C on the occurrence and severity of CAC.A total of 1447 hospitalized patients with coronary computed tomography angiography were selected in this study. According to the CAC score (CACS), patients were divided into calcification group (with CAC, n = 749) and control group (without CAC, n = 698). The calcification group was further divided into low calcification group (CACS < 100, n = 407), medium calcification group (CACS 100-400, n = 203), and high calcification group (CACS≥400, n = 139).Patients with CAC had higher cystatin C level than those in control group (P < .05). With the increase of calcification score, the cystatin C level showed an upward trend. The cystatin C level in the high calcification group was significantly higher than those in the low and medium calcification group (P < .05). ROC curve analysis showed that cystatin C had a high predictive value for the occurrence of CAC [area under the curve 0.640, 95% confidence interval (95% CI) 0.591-0.690, cut-off value 0.945 mg/L, sensitivity 0.683, specificity 0.558, P < .05] and severe CAC (area under the curve 0.638, 95% CI 0.550-0.762, cut-off value 0.965 mg/L, sensitivity 0.865, specificity 0.398, P < .05). Multivariate logistic regression analysis showed that cystatin C was an independent predictor of severe CAC (AOR 3.748, 95% CI 1.138-10.044, P < .05).Cystatin C was significantly associated with the occurrence and severity of CAC, suggesting that cystatin C had the potential as a predictor of CAC. Abbreviations: AOR = adjusted odd ratio, CAC = coronary artery calcification, CACS = coronary artery calcification score, CI = confidence interval, CysC = Cystatin C, eGFR = estimated glomerular filtration rate, IL-6 = interleukin-6, LAD = left anterior descending, LCX = circumflex, LM = left main, MDRD = modification of diet in renal disease trial, OPG = osteoprotegerin, p38MAPK = p38 mitogen-activated protein kinase, RANK = receptor activator of nuclear factor-kB, RANKL = RANK ligand, RCA = right coronary artery, ROC = receiver operating characteristic, TNF-a = tumor necrosis factor-a.

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“…Assessment can also be done by looking for subclinical atherosclerosis, obtained by measuring the thickness of the common carotid intima-media. This is done using Doppler ultrasound [17][18][19]. Currently, indices obtained from the lipid ratios are increasingly used.…”

Section: Introductionmentioning

confidence: 99%

Atherogenic risk assessment of naive HIV-infected patients attending Infectious Diseases Service of Kinshasa University Teaching Hospital, Democratic Republic of the Congo (DRC)

Mbula¹,

Situakibanza²,

Mananga³

et al. 2020

Int J Clin Microbiol Biochem Technol

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Background and aim: Metabolic abnormalities are common in HIV/AIDS. Increasingly, lipid ratios are used as screening tools for dyslipidaemia in these medical conditions. The aim of this study was to assess the ability of 4 lipid ratios to predict cardiovascular risks. Methods: This is a cross-sectional and analytical study included 105 HIV+ patients followed in Kinshasa University Teaching Hospital (KUTH). Four indices [Atherogenic Index of Plasma (AIP), Castelli Risk Index (CRI) I and II, Atherogenic coefficient (AC)] were compared. Statistical analyzis consisted of measuring frequencies and means, Student’s t-tests, ANOVA and Ficher’s exact test, and the calculation of the Kappa value. Results: Lipid ratios predicted respectively the risk in 62% (AIP), 28.6% (CRI-I) and 23.8% (CRI-II). CRI-I and II were elevated, especially in women. The AIP appeared to be a better predictor than CRI-I and II to assess dyslipidaemia in general and the high-risk frequency. The cholesterol detected risk in 66.7% (Low HDL-C), 50% (High LDL-C), 38.9% (High TC and/or TG). The atherogenic risk was higher with age, advanced WHO stage, HIV-TB, HBV-HCV co-infections, smoking and alcohol intake. Haemoglobin (Hb) and CD4 counts were low when the risk was high. Age ≥ 50 years, stage 4 (WHO), CD4s+ ≤ 200 cells/µL were independent factors associated with atherogenic risk. Conclusion: Lipid ratios can be used as reliable tools for assessing cardiovascular risk of naïve HIV-infected patients who received HAART.

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Subclinical Atherosclerosis Imaging in People Living with HIV

Cited by 9 publications

References 175 publications

Prevalence and risk of subclinical carotid atherosclerosis in the global population with HIV: a systematic review and meta-analysis

Prevalence and risk of subclinical carotid atherosclerosis in the global population with HIV: a systematic review and meta-analysis

Association of cystatin C with coronary artery calcification in patients undergoing multidetector computed tomography

Atherogenic risk assessment of naive HIV-infected patients attending Infectious Diseases Service of Kinshasa University Teaching Hospital, Democratic Republic of the Congo (DRC)

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