Coronary Plaque in People With HIV vs Non-HIV Asymptomatic Community and Symptomatic Higher-Risk Populations

Julia Karady; Michael T. Lu; Göran Bergström; Thomas Mayrhofer; Jana Taron; Borek Foldyna; Kayla Paradis; Sara McCallum; Judith A. Aberg; Judith S. Currier; Kathleen V. Fitch; Evelynne S. Fulda; Gerald S. Bloomfield; Edgar T. Overton; Lars Lind; Carl Johan Östgren; Olof Elvstam; Stefan Söderberg; Tomas Jernberg; Rosalie Pepe; Michael P. Dubé; David Mushatt; Carl J. Fichtenbaum; Carlos Malvestutto; Markella V. Zanni; Udo Hoffmann; Heather Ribaudo; Steven K. Grinspoon; Pamela S. Douglas

doi:10.1016/j.jacadv.2024.100968

Coronary Plaque in People With HIV vs Non-HIV Asymptomatic Community and Symptomatic Higher-Risk Populations

Julia Karady, Michael T. Lu, Göran Bergström, Thomas Mayrhofer, Jana Taron, Borek Foldyna, Kayla Paradis, Sara McCallum, Judith A. Aberg, Judith S. Currier, Kathleen V. Fitch, Evelynne S. Fulda, Gerald S. Bloomfield, Edgar T. Overton, Lars Lind, Carl Johan Östgren, Olof Elvstam, Stefan Söderberg, Tomas Jernberg, Rosalie PepeMichael P. Dubé, David Mushatt, Carl J. Fichtenbaum, Carlos Malvestutto, Markella V. Zanni, Udo Hoffmann, Heather Ribaudo, Steven K. Grinspoon, Pamela S. Douglas

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Background: People with HIV (PWH) have a high burden of coronary plaques; however, the comparison to people without known HIV (PwoH) needs clarification. Objectives: The purpose of this study was to determine coronary plaque burden/phenotype in PWH vs PwoH. Methods: Nonstatin using participants from 3 contemporary populations without known coronary plaques with coronary CT were compared: the REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) studying PWH without cardiovascular symptoms at low-to-moderate risk (n = 755); the SCAPIS (Swedish Cardiopulmonary Bioimage Study) of asymptomatic community PwoH at low-to-intermediate cardiovascular risk (n = 23,558); and the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) of stable chest pain PwoH (n = 2,291). The coronary plaque prevalence on coronary CT was compared, and comparisons were stratified by 10-year atherosclerotic cardiovascular disease (ASCVD) risk, age, and coronary artery calcium (CAC) presence. Results: Compared to SCAPIS and PROMISE PwoH, REPRIEVE PWH were younger (50.8 ± 5.8 vs 57.3 ± 4.3 and 60.0 ± 8.0 years; P < 0.001) and had lower ASCVD risk (5.0% ± 3.2% vs 6.0% ± 5.3% and 13.5% ± 11.0%; P < 0.001). More PWH had plaque compared to the asymptomatic cohort (48.5% vs 40.3%; P < 0.001). When stratified by ASCVD risk, PWH had more plaque compared to SCAPIS and a similar prevalence of plaque compared to PROMISE. CAC = 0 was more prevalent in PWH (REPRIEVE 65.2%; SCAPIS 61.6%; PROMISE 49.6%); among CAC = 0, plaque was more prevalent in PWH compared to the PwoH cohorts (REPRIEVE 20.8%; SCAPIS 5.4%; PROMISE 12.3%, P < 0.001). Conclusions: Asymptomatic PWH in REPRIEVE had more plaque than asymptomatic PwoH in SCAPIS but had similar prevalence to a higher-risk stable chest pain cohort in PROMISE. In PWH, CAC = 0 does not reliably exclude plaque.

Original language	English
Article number	100968
Journal	JACC: Advances
Volume	3
Issue number	6
DOIs	https://doi.org/10.1016/j.jacadv.2024.100968
State	Published - Jun 2024

Keywords

asymptomatic community cohort
cardiovascular disease
coronary CT angiography
coronary plaque
people with HIV
stable chest pain

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10.1016/j.jacadv.2024.100968

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Karady, J., Lu, M. T., Bergström, G., Mayrhofer, T., Taron, J., Foldyna, B., Paradis, K., McCallum, S., Aberg, J. A., Currier, J. S., Fitch, K. V., Fulda, E. S., Bloomfield, G. S., Overton, E. T., Lind, L., Östgren, C. J., Elvstam, O., Söderberg, S., Jernberg, T., ... Douglas, P. S. (2024). Coronary Plaque in People With HIV vs Non-HIV Asymptomatic Community and Symptomatic Higher-Risk Populations. JACC: Advances, 3(6), Article 100968. https://doi.org/10.1016/j.jacadv.2024.100968

@article{9a5783b3980b4e93a5038c5e21882204,

title = "Coronary Plaque in People With HIV vs Non-HIV Asymptomatic Community and Symptomatic Higher-Risk Populations",

abstract = "Background: People with HIV (PWH) have a high burden of coronary plaques; however, the comparison to people without known HIV (PwoH) needs clarification. Objectives: The purpose of this study was to determine coronary plaque burden/phenotype in PWH vs PwoH. Methods: Nonstatin using participants from 3 contemporary populations without known coronary plaques with coronary CT were compared: the REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) studying PWH without cardiovascular symptoms at low-to-moderate risk (n = 755); the SCAPIS (Swedish Cardiopulmonary Bioimage Study) of asymptomatic community PwoH at low-to-intermediate cardiovascular risk (n = 23,558); and the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) of stable chest pain PwoH (n = 2,291). The coronary plaque prevalence on coronary CT was compared, and comparisons were stratified by 10-year atherosclerotic cardiovascular disease (ASCVD) risk, age, and coronary artery calcium (CAC) presence. Results: Compared to SCAPIS and PROMISE PwoH, REPRIEVE PWH were younger (50.8 ± 5.8 vs 57.3 ± 4.3 and 60.0 ± 8.0 years; P < 0.001) and had lower ASCVD risk (5.0% ± 3.2% vs 6.0% ± 5.3% and 13.5% ± 11.0%; P < 0.001). More PWH had plaque compared to the asymptomatic cohort (48.5% vs 40.3%; P < 0.001). When stratified by ASCVD risk, PWH had more plaque compared to SCAPIS and a similar prevalence of plaque compared to PROMISE. CAC = 0 was more prevalent in PWH (REPRIEVE 65.2%; SCAPIS 61.6%; PROMISE 49.6%); among CAC = 0, plaque was more prevalent in PWH compared to the PwoH cohorts (REPRIEVE 20.8%; SCAPIS 5.4%; PROMISE 12.3%, P < 0.001). Conclusions: Asymptomatic PWH in REPRIEVE had more plaque than asymptomatic PwoH in SCAPIS but had similar prevalence to a higher-risk stable chest pain cohort in PROMISE. In PWH, CAC = 0 does not reliably exclude plaque.",

keywords = "asymptomatic community cohort, cardiovascular disease, coronary CT angiography, coronary plaque, people with HIV, stable chest pain",

author = "Julia Karady and Lu, {Michael T.} and G{\"o}ran Bergstr{\"o}m and Thomas Mayrhofer and Jana Taron and Borek Foldyna and Kayla Paradis and Sara McCallum and Aberg, {Judith A.} and Currier, {Judith S.} and Fitch, {Kathleen V.} and Fulda, {Evelynne S.} and Bloomfield, {Gerald S.} and Overton, {Edgar T.} and Lars Lind and {\"O}stgren, {Carl Johan} and Olof Elvstam and Stefan S{\"o}derberg and Tomas Jernberg and Rosalie Pepe and Dub{\'e}, {Michael P.} and David Mushatt and Fichtenbaum, {Carl J.} and Carlos Malvestutto and Zanni, {Markella V.} and Udo Hoffmann and Heather Ribaudo and Grinspoon, {Steven K.} and Douglas, {Pamela S.}",

note = "Publisher Copyright: {\textcopyright} 2024",

year = "2024",

month = jun,

doi = "10.1016/j.jacadv.2024.100968",

language = "English",

volume = "3",

journal = "JACC: Advances",

issn = "2772-963X",

publisher = "Elsevier B.V.",

number = "6",

}

Karady, J, Lu, MT, Bergström, G, Mayrhofer, T, Taron, J, Foldyna, B, Paradis, K, McCallum, S, Aberg, JA, Currier, JS, Fitch, KV, Fulda, ES, Bloomfield, GS, Overton, ET, Lind, L, Östgren, CJ, Elvstam, O, Söderberg, S, Jernberg, T, Pepe, R, Dubé, MP, Mushatt, D, Fichtenbaum, CJ, Malvestutto, C, Zanni, MV, Hoffmann, U, Ribaudo, H, Grinspoon, SK & Douglas, PS 2024, 'Coronary Plaque in People With HIV vs Non-HIV Asymptomatic Community and Symptomatic Higher-Risk Populations', JACC: Advances, vol. 3, no. 6, 100968. https://doi.org/10.1016/j.jacadv.2024.100968

TY - JOUR

T1 - Coronary Plaque in People With HIV vs Non-HIV Asymptomatic Community and Symptomatic Higher-Risk Populations

AU - Karady, Julia

AU - Lu, Michael T.

AU - Bergström, Göran

AU - Mayrhofer, Thomas

AU - Taron, Jana

AU - Foldyna, Borek

AU - Paradis, Kayla

AU - McCallum, Sara

AU - Aberg, Judith A.

AU - Currier, Judith S.

AU - Fitch, Kathleen V.

AU - Fulda, Evelynne S.

AU - Bloomfield, Gerald S.

AU - Overton, Edgar T.

AU - Lind, Lars

AU - Östgren, Carl Johan

AU - Elvstam, Olof

AU - Söderberg, Stefan

AU - Jernberg, Tomas

AU - Pepe, Rosalie

AU - Dubé, Michael P.

AU - Mushatt, David

AU - Fichtenbaum, Carl J.

AU - Malvestutto, Carlos

AU - Zanni, Markella V.

AU - Hoffmann, Udo

AU - Ribaudo, Heather

AU - Grinspoon, Steven K.

AU - Douglas, Pamela S.

PY - 2024/6

Y1 - 2024/6

N2 - Background: People with HIV (PWH) have a high burden of coronary plaques; however, the comparison to people without known HIV (PwoH) needs clarification. Objectives: The purpose of this study was to determine coronary plaque burden/phenotype in PWH vs PwoH. Methods: Nonstatin using participants from 3 contemporary populations without known coronary plaques with coronary CT were compared: the REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) studying PWH without cardiovascular symptoms at low-to-moderate risk (n = 755); the SCAPIS (Swedish Cardiopulmonary Bioimage Study) of asymptomatic community PwoH at low-to-intermediate cardiovascular risk (n = 23,558); and the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) of stable chest pain PwoH (n = 2,291). The coronary plaque prevalence on coronary CT was compared, and comparisons were stratified by 10-year atherosclerotic cardiovascular disease (ASCVD) risk, age, and coronary artery calcium (CAC) presence. Results: Compared to SCAPIS and PROMISE PwoH, REPRIEVE PWH were younger (50.8 ± 5.8 vs 57.3 ± 4.3 and 60.0 ± 8.0 years; P < 0.001) and had lower ASCVD risk (5.0% ± 3.2% vs 6.0% ± 5.3% and 13.5% ± 11.0%; P < 0.001). More PWH had plaque compared to the asymptomatic cohort (48.5% vs 40.3%; P < 0.001). When stratified by ASCVD risk, PWH had more plaque compared to SCAPIS and a similar prevalence of plaque compared to PROMISE. CAC = 0 was more prevalent in PWH (REPRIEVE 65.2%; SCAPIS 61.6%; PROMISE 49.6%); among CAC = 0, plaque was more prevalent in PWH compared to the PwoH cohorts (REPRIEVE 20.8%; SCAPIS 5.4%; PROMISE 12.3%, P < 0.001). Conclusions: Asymptomatic PWH in REPRIEVE had more plaque than asymptomatic PwoH in SCAPIS but had similar prevalence to a higher-risk stable chest pain cohort in PROMISE. In PWH, CAC = 0 does not reliably exclude plaque.

AB - Background: People with HIV (PWH) have a high burden of coronary plaques; however, the comparison to people without known HIV (PwoH) needs clarification. Objectives: The purpose of this study was to determine coronary plaque burden/phenotype in PWH vs PwoH. Methods: Nonstatin using participants from 3 contemporary populations without known coronary plaques with coronary CT were compared: the REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV) studying PWH without cardiovascular symptoms at low-to-moderate risk (n = 755); the SCAPIS (Swedish Cardiopulmonary Bioimage Study) of asymptomatic community PwoH at low-to-intermediate cardiovascular risk (n = 23,558); and the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) of stable chest pain PwoH (n = 2,291). The coronary plaque prevalence on coronary CT was compared, and comparisons were stratified by 10-year atherosclerotic cardiovascular disease (ASCVD) risk, age, and coronary artery calcium (CAC) presence. Results: Compared to SCAPIS and PROMISE PwoH, REPRIEVE PWH were younger (50.8 ± 5.8 vs 57.3 ± 4.3 and 60.0 ± 8.0 years; P < 0.001) and had lower ASCVD risk (5.0% ± 3.2% vs 6.0% ± 5.3% and 13.5% ± 11.0%; P < 0.001). More PWH had plaque compared to the asymptomatic cohort (48.5% vs 40.3%; P < 0.001). When stratified by ASCVD risk, PWH had more plaque compared to SCAPIS and a similar prevalence of plaque compared to PROMISE. CAC = 0 was more prevalent in PWH (REPRIEVE 65.2%; SCAPIS 61.6%; PROMISE 49.6%); among CAC = 0, plaque was more prevalent in PWH compared to the PwoH cohorts (REPRIEVE 20.8%; SCAPIS 5.4%; PROMISE 12.3%, P < 0.001). Conclusions: Asymptomatic PWH in REPRIEVE had more plaque than asymptomatic PwoH in SCAPIS but had similar prevalence to a higher-risk stable chest pain cohort in PROMISE. In PWH, CAC = 0 does not reliably exclude plaque.

KW - asymptomatic community cohort

KW - cardiovascular disease

KW - coronary CT angiography

KW - coronary plaque

KW - people with HIV

KW - stable chest pain

UR - http://www.scopus.com/inward/record.url?scp=85191779675&partnerID=8YFLogxK

U2 - 10.1016/j.jacadv.2024.100968

DO - 10.1016/j.jacadv.2024.100968

M3 - Article

AN - SCOPUS:85191779675

SN - 2772-963X

VL - 3

JO - JACC: Advances

JF - JACC: Advances

IS - 6

M1 - 100968

ER -

Coronary Plaque in People With HIV vs Non-HIV Asymptomatic Community and Symptomatic Higher-Risk Populations

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Keywords

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