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HIV and coronary artery disease

Matthew J Feinstein, Brian Poole, Pedro Engel Gonzalez, Anna E Pawlowski, Daniel Schneider, Tim S Provias, Frank J Palella, Chad J Achenbach, Donald M Lloyd-Jones
BACKGROUND: HIV-infected persons develop coronary artery disease (CAD) more commonly and earlier than uninfected persons; however, the role of non-invasive testing to stratify CAD risk in HIV is not well defined. METHODS AND RESULTS: Patients were selected from a single-center electronic cohort of HIV-infected patients and uninfected controls matched 1:2 on age, sex, race, and type of cardiovascular testing performed. Patients with abnormal echocardiographic or nuclear stress testing who subsequently underwent coronary angiography were included...
October 13, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Sion K Roy, Michelle M Estrella, Annie T Darilay, Matthew J Budoff, Lisa P Jacobson, Mallory D Witt, Lawrence A Kingsley, Wendy S Post, Frank J Palella
BACKGROUND: Decreased kidney function and greater albuminuria are associated with increased incidence and extent of coronary artery calcium (CAC). We investigated whether the associations between kidney function and urine protein-to-creatinine ratio (UPCR) with CAC differ by HIV serostatus. METHODS: Using data from the Multicenter AIDS Cohort Study, a prospective multicenter US study of men who have sex with men, we carried out a cross-sectional study comprised of 592 HIV-infected (HIV+) and 378 uninfected (HIV-) men who underwent noncontrast computed tomography to measure CAC...
September 8, 2016: Coronary Artery Disease
J Nadel, C J Holloway
HIV infection is now considered a chronic, treatable disease, although treatment is associated with increased rates of coronary artery disease (CAD). Increased risk of CAD in HIV-infected patients has been associated with the inflammatory sequelae of the infection as well as the greater prevalence of cardiac risk factors in HIV-positive populations and the side effects of life-prolonging antiretroviral therapies. Patients with HIV infection now have a 1.5 to 2-fold greater risk of developing CAD compared with noninfected individuals, raising the independent risk of CAD in HIV infection to levels similar to those in diabetes...
August 24, 2016: HIV Medicine
James Nadel, Eoin O'Dwyer, Sam Emmanuel, Justyn Huang, Sarat Cheruvu, Neville Sammel, Bruce Brew, James Otton, Cameron J Holloway
BACKGROUND: Human immunodeficiency virus (HIV) infection is considered a chronic, treatable disease, although treatment is associated with increased rates of coronary artery disease (CAD). We analyzed the utility of coronary CTA in the assessment of CAD among HIV patients and explored whether HIV patients are at greater risk of associated morbidity and mortality compared to HIV-negative controls. METHODS: In a retrospective, single center cohort study 97 males without history of previous coronary artery disease who had undergone coronary CTA between 2011 and 2014 was analyzed, including 32 HIV positive patients and 65 matched HIV negative controls...
September 2016: Journal of Cardiovascular Computed Tomography
Judith M Haissman, Anna K Haugaard, Andreas Knudsen, Ulrik S Kristoffersen, Ingebjørg Seljeflot, Karin K Pedersen, Anne-Mette Lebech, Philip Hasbak, Andreas Kjær, Sisse R Ostrowski, Jan Gerstoft, Marius Trøseid, Susanne D Nielsen
BACKGROUND: Cardiovascular disease (CVD) contributes to excess morbidity and mortality in HIV infection, and endothelial dysfunction may contribute to this pattern. We aimed to determine endothelial function in treated and untreated HIV-infected individuals and investigate potential associations with viral replication, immune activation, coagulation, platelet function, and subclinical atherosclerosis. METHODS: Asymmetric dimethylarginine (ADMA, marker of endothelial dysfunction) and soluble CD14 (sCD14, marker of monocyte activation) were measured in plasma from two previously established cross-sectional cohorts: Cohort A including 50 untreated and 50 anti-retroviral therapy (ART) treated HIV-infected individuals with previously assessed coagulation and platelet function, and Cohort B including 105 HIV-infected individuals on ART and 105 uninfected controls with previously assessed coronary artery calcium score (CACS), myocardial perfusion defects (MPD), and carotid intima-media thickness (cIMT)...
August 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Frank J Palella, Rebeccah McKibben, Wendy S Post, Xiuhong Li, Matthew Budoff, Lawrence Kingsley, Mallory D Witt, Lisa P Jacobson, Todd T Brown
Methods.  In a cross-sectional substudy of the Multicenter AIDS Cohort Study, noncontrast cardiac computed tomography (CT) scanning for coronary artery calcium (CAC) scoring was performed on all men, and, for men with normal renal function, coronary CT angiography (CTA) was performed. Associations between fat depots (visceral adipose tissue [VAT], abdominal subcutaneous adipose tissue [aSAT], and thigh subcutaneous adipose tissue [tSAT]) with coronary plaque presence and extent were assessed with logistic and linear regression adjusted for age, race, cardiovascular disease (CVD) risk factors, body mass index (BMI), and human immunodeficiency virus (HIV) parameters...
April 2016: Open Forum Infectious Diseases
Paolo Raggi, Catherine Corwin
Many sources have highlighted the high incidence of premature cardiovascular events in HIV infected patients. This raises the suspicion of an accelerated ageing of the vascular system in this disease characterized by chronic systemic subliminal inflammation and immune dysregulation. Unfortunately all currently available risk assessment algorithms based on traditional risk factors, and even those containing more HIV-specific factors, fail to accurately predict risk in a large proportion of patients. In the general population several models have implemented imaging data to refine risk assessment, and the concept of vascular ageing has been of value in improving the performance of these algorithms...
July 13, 2016: Virulence
C Jacomet, G Illes, F Kwiatkowski, M Vidal, N Mrozek, C Aumeran, V Corbin, O Lesens, H Laurichesse, P Bailly
OBJECTIVES: To study valve appearance and the presence of valve disease in a cohort of people living with HIV (PLHIV). DESIGN: A prospective study of PLHIV examined at the cardiology department of the Clermont Ferrand university hospital group (CHU) between January 1, 2012, and December 31, 2014. Were excluded those with a history of infection associated with a possible endocarditis. METHODS: Demographic, medical characteristics and cardiovascular disease risk factors at time of cardiovascular examination and Doppler-echocardiography were recorded and analyzed...
October 1, 2016: International Journal of Cardiology
Hossein Bahrami, Matthew Budoff, Sabina A Haberlen, Pantea Rezaeian, Kerunne Ketlogetswe, Russell Tracy, Frank Palella, Mallory D Witt, Michael V McConnell, Lawrence Kingsley, Wendy S Post
BACKGROUND: Despite evidence for higher risk of coronary artery disease among HIV+ individuals, the underlying mechanisms are not well understood. We investigated associations of inflammatory markers with subclinical coronary artery disease in 923 participants of the Multicenter AIDS Cohort Study (575 HIV+ and 348 HIV- men) who underwent noncontrast computed tomography scans for coronary artery calcification, the majority (n=692) also undergoing coronary computed tomography angiography...
June 2016: Journal of the American Heart Association
A Filipovic-Pierucci, A Rigault, A Fagot-Campagna, P Tuppin
BACKGROUND: This study uses healthcare consumption to compare the health status of beneficiaries of the French national health insurance general scheme between individuals living in French overseas territories (FOT) and those living in metropolitan France. METHODS: Data were extracted from the French national health insurance database (Sniiram) for 2012, using algorithms, 56 groups of diseases and 27 groups of hospital activity were isolated. Standardized morbidity ratio for age and sex (SMR) were used to compare FOT to mainland France...
June 2016: Revue D'épidémiologie et de Santé Publique
Anne K Monroe, Sabina A Haberlen, Wendy S Post, Frank J Palella, Lawrence A Kinsgley, Mallory D Witt, Matthew Budoff, Lisa P Jacobson, Todd T Brown
OBJECTIVE: To study cardiovascular disease risk score utility, we compared the association between Framingham Risk Score (FRS)/pooled cohort equation (PCE) categories and coronary artery plaque presence by HIV serostatus and evaluated whether D : A : D risk category more accurately identifies plaque in HIV-infected men. DESIGN: Cross-sectional analysis within a substudy of the Multicenter AIDS Cohort Study. METHODS: Cardiac computed tomography was performed to assess coronary plaque...
August 24, 2016: AIDS
Justin Heizer, Timothy C Petersen, Mark C Flemmer
HIV infection can cause multiple deleterious effects on the cardiovascular system. Emerging evidence has supported a direct association between HIV infection and accelerated atherosclerosis. The mechanism for atherosclerosis in HIV-positive patients is multifactorial, an interplay between conventional risk factors, HIV itself and highly active antiretroviral therapy. The case described is a 29-year-old man with HIV, non-adherent to antiretroviral therapy and with few cardiovascular risk factors, who presented with chest pain and non-ST elevation myocardial infarction...
May 2016: Oxford Medical Case Reports
Hong Lai, Richard Moore, David D Celentano, Gary Gerstenblith, Glenn Treisman, Jeanne C Keruly, Thomas Kickler, Ji Li, Shaoguang Chen, Shenghan Lai, Elliot K Fishman
BACKGROUND: The key objectives of this study were to examine whether HIV infection itself is associated with subclinical coronary atherosclerosis and the potential contributions of cocaine use and antiretroviral therapies (ARTs) to subclinical coronary artery disease (CAD) in HIV-infected persons. METHODS AND RESULTS: Between June 2004 and February 2015, 1429 African American (AA) adults with/without HIV infection in Baltimore, Maryland, were enrolled in an observational study of the effects of HIV infection, exposure to ART, and cocaine use on subclinical CAD...
March 2016: Journal of the American Heart Association
Jessica L Castilho, Bryan E Shepherd, John Koethe, Megan Turner, Sally Bebawy, James Logan, William B Rogers, Stephen Raffanti, Timothy R Sterling
OBJECTIVE: In virologically suppressed HIV-infected adults, noncommunicable diseases (NCDs) have been associated with immune senescence and low CD4/CD8 lymphocyte ratio. Age differences in the relationship between CD4/CD8 ratio and NCDs have not been described. DESIGN: Observational cohort study. METHODS: We assessed CD4/CD8 ratio and incident NCDs (cardiovascular, cancer, liver, and renal diseases) in HIV-infected adults started on antiretroviral therapy between 1998 and 2012...
March 27, 2016: AIDS
Panteha Rezaeian, P Elliott Miller, Sabina A Haberlen, Aryabod Razipour, Hossein Bahrami, Romeo Castillo, Mallory D Witt, Lawrence Kingsley, Frank J Palella, Rine Nakanishi, Suguru Matsumoto, Anas Alani, Lisa P Jacobson, Wendy S Post, Matthew J Budoff
INTRODUCTION: Previous studies have demonstrated an association between HIV infection and coronary artery disease (CAD); little is known about potential associations between HIV infection and extra-coronary calcification (ECC). METHODS: We analyzed 621 HIV infected (HIV+) and 384 HIV uninfected (HIV-) men from the Multicenter AIDS Cohort Study who underwent non-contrast computed tomography (CT) from 2010-2013. Agatston scores were calculated for mitral annular calcification (MAC), aortic valve calcification (AVC), aortic valve ring calcification (AVRC), and thoracic aortic calcification (TAC)...
May 2016: Journal of Cardiovascular Computed Tomography
Robert C Kaplan, David B Hanna, Jorge R Kizer
While mortality rates related to cardiovascular disease (CVD) have decreased over time among adults with HIV, excess risk of CVD in the HIV-infected population may persist despite highly active antiretroviral therapy (HAART) treatment and aggressive CVD risk factor control. Beyond atherosclerotic CVD, recent studies suggest that HIV infection may be associated with left ventricular systolic and diastolic function, interstitial myocardial fibrosis, and increased cardiac fat infiltration. Thus, with the increasing average age of the HIV-infected population, heart failure and arrhythmic disorders may soon rival coronary artery disease as the most prevalent forms of CVD...
February 2016: Current HIV/AIDS Reports
Nath Zungsontiporn, Raquel R Tello, Guangxiang Zhang, Brooks I Mitchell, Matthew Budoff, Kalpana J Kallianpur, Beau K Nakamoto, Sheila M Keating, Philip J Norris, Lishomwa C Ndhlovu, Scott A Souza, Cecilia M Shikuma, Dominic C Chow
BACKGROUND: Persistent inflammation and immune activation has been hypothesized to contribute to increased prevalence of subclinical atherosclerosis and cardiovascular disease (CVD) risk in patients with chronic HIV infection. In this study, we examined the correlation of peripheral monocyte subsets and soluble biomarkers of inflammation to coronary artery calcium (CAC) progression, as measured by cardiac computed tomography scan. METHODS: We conducted a longitudinal analysis utilizing baseline data of 78 participants with HIV infection on stable antiretroviral therapy (ART) in the Hawaii Aging with HIV-Cardiovascular study who had available baseline monocyte subset analysis as well as CAC measurement at baseline and at 2-year follow up...
2016: PloS One
Michael I Brener, Wendy S Post, Sabina A Haberlen, Long Zhang, Frank J Palella, Lisa P Jacobson, Adrian S Dobs, Richard T George, Mallory D Witt, Matthew Budoff, Lawrence A Kingsley, Todd T Brown
The relation between insulin resistance (IR) and coronary artery disease in patients with human immunodeficiency virus (HIV) infection remains incompletely defined. Fasting serum insulin and glucose measurements from 448 HIV-infected and 306 uninfected men enrolled in the Multicenter AIDS Cohort Study were collected at semiannual visits from 2003 to 2013 and used to compute the homeostatic model assessment of IR (HOMA-IR). Coronary computed tomographic angiography (CTA) was performed at the end of the study period to characterize coronary pathology...
March 15, 2016: American Journal of Cardiology
Nath Zungsontiporn, Lishomwa C Ndhlovu, Brooks I Mitchell, James H Stein, Kalpana J Kallianpur, Beau Nakamoto, Sheila M Keating, Philip J Norris, Scott A Souza, Cecilia M Shikuma, Dominic C Chow
OBJECTIVE: This study aimed to evaluate the relationship between inflammatory biomarkers and endothelial dysfunction (ED), as measured by brachial artery flow-mediated dilation (FMD). METHODS: We conducted a cross-sectional analysis utilizing baseline data of 135 participants with HIV infection on stable antiretroviral therapy (ART) in the Hawaii Aging with HIV-Cardiovascular (HAHC-CVD) study who had available baseline inflammatory biomarkers and brachial artery FMD measurements...
November 2015: HIV Clinical Trials
Ke-Hsin Ting, Kwo-Chang Ueng, Whei-Ling Chiang, Ying-Erh Chou, Shun-Fa Yang, Po-Hui Wang
The chemokine receptor CCR5 polymorphism, which confers resistance to HIV infection, has been associated with reduced risk of cardiovascular disease. However, the association of the chemokine, CCL5, and its receptor, CCR5, polymorphism and coronary artery disease (CAD) in the Taiwanese has not been studied. In this study, 483 subjects who received elective coronary angiography were recruited from Chung Shan Medical University Hospital. CCL5-403 and CCR5-59029 were determined by polymerase chain reaction-restriction fragment length polymorphism...
2015: Evidence-based Complementary and Alternative Medicine: ECAM
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