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首页> 外文期刊>AIDS >Increased prevalence of subclinical coronary atherosclerosis detected by coronary computed tomography angiography in HIV-infected men.
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Increased prevalence of subclinical coronary atherosclerosis detected by coronary computed tomography angiography in HIV-infected men.

机译：在受HIV感染的男性中，通过冠状动脉计算机断层扫描血管造影术发现的亚临床冠状动脉粥样硬化患病率增加。

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OBJECTIVE: The degree of subclinical coronary atherosclerosis in HIV-infected patients is unknown. We investigated the degree of subclinical atherosclerosis and the relationship of traditional and nontraditional risk factors to early atherosclerotic disease using coronary computed tomography angiography. DESIGN AND METHODS: Seventy-eight HIV-infected men (age 46.5 +/- 6.5 years and duration of HIV 13.5 +/- 6.1 years, CD4 T lymphocytes 523 +/- 282; 81% undetectable viral load), and 32 HIV-negative men (age 45.4 +/- 7.2 years) with similar demographic and coronary artery disease (CAD) risk factors, without history or symptoms of CAD, were prospectively recruited. 64-slice multidetector row computed tomography coronary angiography was performed to determine prevalence of coronary atherosclerosis, coronary stenosis, and quantitative plaque burden. RESULTS HIV-infected men demonstrated higher prevalence of coronary atherosclerosis than non-HIV-infected men (59 vs. 34%; P = 0.02), higher coronary plaque volume [55.9 (0-207.7); median (IQR) vs. 0 (0-80.5) microl; P = 0.02], greater number of coronary segments with plaque [1 (0-3) vs. 0 (0-1) segments; P = 0.03], and higher prevalence of Agatston calcium score more than 0 (46 vs. 25%, P = 0.04), despite similar Framingham 10-year risk for myocardial infarction, family history of CAD, and smoking status. Among HIV-infected patients, Framingham score, total cholesterol, low-density lipoprotein, CD4/CD8 ratio, and monocyte chemoattractant protein 1 were significantly associated with plaque burden. Duration of HIV infection was significantly associated with plaque volume (P = 0.002) and segments with plaque (P = 0.0009) and these relationships remained significant after adjustment for age, traditional risk factors, or duration of antiretroviral therapy. A total of 6.5% (95% confidence interval 2-15%) of our study population demonstrated angiographic evidence of obstructive CAD (>70% luminal narrowing) as compared with 0% in controls. CONCLUSION: Young, asymptomatic, HIV-infected men with long-standing HIV disease demonstrate an increased prevalence and degree of coronary atherosclerosis compared with non-HIV-infected patients. Both traditional and nontraditional risk factors contribute to atherosclerotic disease in HIV-infected patients.
机译：目的：HIV感染者的亚临床冠状动脉粥样硬化程度尚不清楚。我们使用冠状动脉计算机断层血管造影术研究了亚临床动脉粥样硬化程度以及传统和非传统危险因素与早期动脉粥样硬化疾病的关系。设计与方法：78名受HIV感染的男性（年龄46.5 +/- 6.5岁，艾滋病毒持续时间13.5 +/- 6.1年，CD4 T淋巴细胞523 +/- 282; 81％不可检测的病毒载量），以及32例HIV-前瞻性招募了具有相似的人口统计学和冠状动脉疾病（CAD）危险因素，无CAD历史或症状的阴性男性（45.4 +/- 7.2岁）。进行64层多排螺旋CT冠状动脉造影检查，以确定冠状动脉粥样硬化，冠状动脉狭窄和斑块负荷的患病率。结果艾滋病毒感染的男性比非艾滋病毒感染的男性表现出更高的冠状动脉粥样硬化患病率（59比34％; P = 0.02），冠状动脉斑块量更高[55.9（0-207.7）;中位数（IQR）与0（0-80.5）微升; P = 0.02]，具有斑块的冠状动脉节段的数量更大[1（0-3）vs. 0（0-1）节; P = 0.03]，尽管弗雷明汉（Framingham）十年的心肌梗死风险，CAD家族史和吸烟状况相似，但Agatston钙评分的较高患病率大于0（46 vs. 25％，P = 0.04）。在感染HIV的患者中，弗雷明汉评分，总胆固醇，低密度脂蛋白，CD4 / CD8比值和单核细胞趋化蛋白1与牙菌斑负担显着相关。 HIV感染的持续时间与斑块量（P = 0.002）和斑块段（P = 0.0009）显着相关，并且在调整了年龄，传统危险因素或抗逆转录病毒治疗的时间后，这些关系仍然很明显。共有6.5％（95％的置信区间为2-15％）的研究人群显示了阻塞性CAD（> 70％的腔狭窄）的血管造影证据，而对照组为0％。结论：与未感染艾滋病毒的患者相比，患有艾滋病毒且长期存在艾滋病的年轻无症状男性表现出更高的患病率和冠状动脉粥样硬化程度。传统和非传统危险因素均会导致HIV感染患者的动脉粥样硬化疾病。

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