Carotid artery atherosclerosis is associated with mortality in HIV-positive women and men

被引：28

作者：

Hanna, David B. ^{[1
]}

Moon, Jee-Young ^{[1
]}

Haberlen, Sabina A. ^{[2
]}

French, Audrey L. ^{[3
]}

Palella, Frank J., Jr. ^{[4
]}

Gange, Stephen J. ^{[2
]}

Witt, Mallory D. ^{[5
]}

Kassaye, Seble ^{[6
]}

Lazar, Jason M. ^{[7
]}

Tien, Phyllis C. ^{[8
,9
]}

Feinstein, Matthew J. ^{[10
]}

Kingsley, Lawrence A. ^{[11
,12
]}

Post, Wendy S. ^{[2
,13
]}

Kaplan, Robert C. ^{[1
,14
]}

Hodis, Howard N. ^{[15
]}

Anastos, Kathryn ^{[1
,16
]}

机构：

[1] Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, 1300 Morris Pk Ave,Belfer 1306C, Bronx, NY 10461 USA

[2] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA

[3] John H Stroger Jr Hosp Cook Cty, Dept Infect Dis, Chicago, IL USA

[4] Northwestern Univ, Dept Med, Med Ctr, Chicago, IL 60611 USA

[5] Los Angeles Biomed Res Inst Harbor UCLA, Dept Med, Torrance, CA USA

[6] Georgetown Univ, Med Ctr, Dept Med, Washington, DC 20007 USA

[7] Suny Downstate Med Ctr, Dept Med, Brooklyn, NY 11203 USA

[8] Univ Calif San Francisco, Dept Med, San Francisco, CA USA

[9] Univ Calif San Francisco, Dept Vet Affairs, San Francisco, CA USA

[10] Northwestern Univ, Dept Med, Feinberg Sch Med, Chicago, IL 60611 USA

[11] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA

[12] Univ Pittsburgh, Dept Infect Dis & Microbiol, Pittsburgh, PA USA

[13] Johns Hopkins Sch Med, Dept Med, Baltimore, MD USA

[14] Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, 1124 Columbia St, Seattle, WA 98104 USA

[15] Univ Southern Calif, Atherosclerosis Res Unit, Los Angeles, CA USA

[16] Montefiore Med Ctr, Dept Med, Bronx, NY 10467 USA

来源：

AIDS | 2018年 / 32卷 / 16期

基金：

美国国家卫生研究院;

关键词：

arterial stiffness; atherosclerosis; HIV; intima-media thickness; mortality; plaque; INTIMA-MEDIA THICKNESS; HUMAN-IMMUNODEFICIENCY-VIRUS; MULTICENTER AIDS COHORT; SEX-DIFFERENCES; MYOCARDIAL-INFARCTION; CARDIOVASCULAR RISK; INFECTED PATIENTS; PLAQUE; INDIVIDUALS; STIFFNESS;

D O I：

10.1097/QAD.0000000000001972

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Objective: Among people with HIV, there are few long-term studies of noninvasive ultrasound-based measurements of the carotid artery predicting major health events. We hypothesized that such measurements are associated with 10-year mortality in the Women's Interagency HIV Study (WIHS) and Multicenter AIDS Cohort Study (MACS), and that associations differ by HIV serostatus. Design: Nested cohort study, Methods: Participants without coronary heart disease underwent B-mode carotid artery ultrasound, with measurement of common carotid artery intima media thickness (IMT); carotid artery plaque (focal IMT > 1.5 mm) at six locations; and Young's modulus of elasticity, a measure of arterial stiffness. We examined all-cause mortality using Cox models, controlling for demographic, behavioral, cardiometabolic, and HIV-related factors. Results: Among 1722 women (median age 40 years, 90% nonwhite, 71% HIV-positive) and 1304 men (median age 50, 39% nonwhite, 62% HIV-positive), 11% died during follow-up. Mortality was higher among HIV-positive women [19.9 deaths/1000 person years, 95% confidence interval (CI) 14.7-28.8] than HIV-positive men (15.1/1000, 95% CI 8.3-26.8). In adjusted analyses, plaque was associated with mortality (hazard ratio 1.44, 95% CI 1.10-1.88) regardless of HIV serostatus, and varied by sex (among women, hazard ratio 1.06, 95% CI 0.74-1.52; among men; hazard ratio 2.19, 95% CI 1.41-3.43). The association of plaque with mortality was more pronounced among HIV-negative (hazard ratio 3.87, 95% 1.95-7.66) than HIV-positive participants (hazard ratio 1.35, 95% CI 1.00-1.84). Arterial stiffness was also associated with mortality (hazard ratio 1.43 for highest versus lowest quartile, 95% CI 1.02-2.01). Greater common carotid artery-IMT was not associated with mortality. Conclusion: Carotid artery plaque was predictive of mortality, with differences observed by sex and HIV serostalus. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.

引用

页码：2393 / 2403

页数：11

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