Τίτλος:
Detection of Subclinical Coronary Artery Lesions by Framingham Risk Score, Peripheral Artery Atheromatosis and Coronary Artery Calcium Score: A Pilot Study in Asymptomatic Individuals Living with HIV
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The incidence of acute coronary events is increased among people living with HIV (PLWH), but there is no risk estimation score, nor a surrogate biomarker able to predict subclinical coronary artery disease (sCAD). We assessed the performance of: (i) Framingham risk score (FRMs), (ii) peripheral (carotid and femoral) artery atheromatosis, and (iii) coronary artery calcium (CACs) score, to detect the presence of sCAD, in PLWH. In a cohort of PLWH free of cardiovascular disease (CVD), we measured sCAD and CACs by computed tomography, calculated FRMs, and assessed carotid/femoral plaques by ultrasound. In 56 participants (age: 49 ± 10 years, men: 88%, FRMs: 7.2 ± 6.9; mean number of carotid/femoral plaques: 1.4 ± 1.5; CACs >0 present in 59%, median CACs 0.9 [IQR 0-22]): (i) minimal sCAD (stenosis 1%-24%; present in 30%) and mild sCAD (25%-49%, 25%) were effectively detected by FRMs, number of plaques, and CACs [area under the curve (AUC) of CACs was better than that of both FRM and plaques, p < .05]; (ii) moderate sCAD (stenosis 50%-69%; present in 8.9%) was detected by number of plaques and CACs, but similar AUC (0.969 vs. 0.867, respectively, p = NS); and (iii) severe sCAD (70%-99%, present in only 3 [5.4%]) was detected only by CACs. A high prevalence of sCAD in asymptomatic PLWH free of CVD was detected; CACs is a highly efficient biomarker to detect all grades of sCAD, however, the number of carotid/femoral plaques combined is also a very promising - lower cost and radiation free - surrogate biomarker. Future, larger studies are needed to verify these results. © 2021 Mary Ann Liebert Inc.
Συγγραφείς:
Kapelios, C.J.
Masouris, G.
Argyris, A.
Konstantinidis, I.
Gamaletsou, M.N.
Kontos, A.
Zormpala, A.
Spiliopoulos, S.
Sipsas, N.V.
Protogerou, A.D.
Περιοδικό:
AIDS Research and Human Retroviruses
Εκδότης:
Mary Ann Liebert, Inc. 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA
Λέξεις-κλειδιά:
adult; Article; atheromatosis; carotid atherosclerosis; clinical assessment; computed tomographic angiography; controlled study; coronary artery calcium score; coronary artery disease; cross-sectional study; female; femoral artery; Framingham risk score; human; Human immunodeficiency virus; Human immunodeficiency virus infected patient; major clinical study; male; middle aged; pilot study; prevalence; priority journal; ultrasound; child; complication; coronary angiography; coronary artery disease; coronary blood vessel; diagnostic imaging; Human immunodeficiency virus infection; predictive value; risk assessment; risk factor, calcium, Calcium; Child; Coronary Angiography; Coronary Artery Disease; Coronary Vessels; HIV Infections; Humans; Male; Pilot Projects; Predictive Value of Tests; Risk Assessment; Risk Factors
DOI:
10.1089/aid.2021.0015
