Pericoronary Adipose Tissue Density, Inflammation, and Subclinical Coronary Artery Disease Among People With HIV in the REPRIEVE Cohort

Borek Foldyna; Thomas Mayrhofer; Markella V. Zanni; Asya Lyass; Radhika Barve; Julia Karady; Sara McCallum; Tricia H. Burdo; Kathleen V. Fitch; Kayla Paradis; Evelynne S. Fulda; Marissa R. Diggs; Gerald S. Bloomfield; Carlos D. Malvestutto; Carl J. Fichtenbaum; Judith A. Aberg; Judith S. Currier; Heather J. Ribaudo; Udo Hoffmann; Michael T. Lu; Pamela S. Douglas; Steven K. Grinspoon

doi:10.1093/cid/ciad419

Pericoronary Adipose Tissue Density, Inflammation, and Subclinical Coronary Artery Disease Among People With HIV in the REPRIEVE Cohort

Borek Foldyna, Thomas Mayrhofer, Markella V. Zanni, Asya Lyass, Radhika Barve, Julia Karady, Sara McCallum, Tricia H. Burdo, Kathleen V. Fitch, Kayla Paradis, Evelynne S. Fulda, Marissa R. Diggs, Gerald S. Bloomfield, Carlos D. Malvestutto, Carl J. Fichtenbaum, Judith A. Aberg, Judith S. Currier, Heather J. Ribaudo, Udo Hoffmann, Michael T. LuPamela S. Douglas, Steven K. Grinspoon

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Abstract

Background. Pericoronary adipose tissue (PCAT) may influence plaque development through inflammatory mechanisms. We assessed PCAT density, as a measure of pericoronary inflammation, in relationship to coronary plaque among people with human immunodeficiency virus (HIV [PWH]) and to a matched control population. Methods. In this baseline analysis of 727 participants of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) Mechanistic Substudy, we related computed tomography–derived PCAT density to presence and extent (Leaman score) of coronary artery disease (CAD), noncalcified plaque, coronary artery calcium (CAC), and vulnerable plaque features using multivariable logistic regression analyses. We further compared the PCAT density between PWH and age, sex, body mass index, CAC score, and statin use–matched controls from the community-based Framingham Heart Study (N = 464), adjusting for relevant clinical covariates. Results. Among 727 REPRIEVE participants (age 50.8 ± 5.8 years; 83.6% [608/727] male), PCAT density was higher in those with (vs without) coronary plaque, noncalcified plaque, CAC >0, vulnerable plaque, and high CAD burden (Leaman score >5) (P < .001 for each comparison). PCAT density related to prevalent coronary plaque (adjusted odds ratio [per 10 HU]: 1.44; 95% confidence interval, 1.22–1.70; P < .001), adjusted for clinical cardiovascular risk factors, body mass index, and systemic immune/inflammatory biomarkers. Similarly, PCAT density related to CAC >0, noncalcified plaque, vulnerable plaque, and Leaman score >5 (all P ≤ .002). PCAT density was greater among REPRIEVE participants versus Framingham Heart Study (−88.2 ± 0.5 HU versus −90.6 ± 0.4 HU; P < .001). Conclusions. Among PWH in REPRIEVE, a large primary cardiovascular disease prevention cohort, increased PCAT density independently associated with prevalence and severity of coronary plaque, linking increased coronary inflammation to CAD in PWH.

Original language	English
Pages (from-to)	1676-1686
Number of pages	11
Journal	Clinical Infectious Diseases
Volume	77
Issue number	12
DOIs	https://doi.org/10.1093/cid/ciad419
State	Published - 15 Dec 2023

Keywords

HIV
coronary artery disease
coronary plaque
inflammation
pericoronary adipose tissue

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10.1093/cid/ciad419

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Foldyna, B., Mayrhofer, T., Zanni, M. V., Lyass, A., Barve, R., Karady, J., McCallum, S., Burdo, T. H., Fitch, K. V., Paradis, K., Fulda, E. S., Diggs, M. R., Bloomfield, G. S., Malvestutto, C. D., Fichtenbaum, C. J., Aberg, J. A., Currier, J. S., Ribaudo, H. J., Hoffmann, U., ... Grinspoon, S. K. (2023). Pericoronary Adipose Tissue Density, Inflammation, and Subclinical Coronary Artery Disease Among People With HIV in the REPRIEVE Cohort. Clinical Infectious Diseases, 77(12), 1676-1686. https://doi.org/10.1093/cid/ciad419

@article{9f7ee43d66dd4b94871326e605bf9f18,

title = "Pericoronary Adipose Tissue Density, Inflammation, and Subclinical Coronary Artery Disease Among People With HIV in the REPRIEVE Cohort",

abstract = "Background. Pericoronary adipose tissue (PCAT) may influence plaque development through inflammatory mechanisms. We assessed PCAT density, as a measure of pericoronary inflammation, in relationship to coronary plaque among people with human immunodeficiency virus (HIV [PWH]) and to a matched control population. Methods. In this baseline analysis of 727 participants of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) Mechanistic Substudy, we related computed tomography–derived PCAT density to presence and extent (Leaman score) of coronary artery disease (CAD), noncalcified plaque, coronary artery calcium (CAC), and vulnerable plaque features using multivariable logistic regression analyses. We further compared the PCAT density between PWH and age, sex, body mass index, CAC score, and statin use–matched controls from the community-based Framingham Heart Study (N = 464), adjusting for relevant clinical covariates. Results. Among 727 REPRIEVE participants (age 50.8 ± 5.8 years; 83.6% [608/727] male), PCAT density was higher in those with (vs without) coronary plaque, noncalcified plaque, CAC >0, vulnerable plaque, and high CAD burden (Leaman score >5) (P < .001 for each comparison). PCAT density related to prevalent coronary plaque (adjusted odds ratio [per 10 HU]: 1.44; 95% confidence interval, 1.22–1.70; P < .001), adjusted for clinical cardiovascular risk factors, body mass index, and systemic immune/inflammatory biomarkers. Similarly, PCAT density related to CAC >0, noncalcified plaque, vulnerable plaque, and Leaman score >5 (all P ≤ .002). PCAT density was greater among REPRIEVE participants versus Framingham Heart Study (−88.2 ± 0.5 HU versus −90.6 ± 0.4 HU; P < .001). Conclusions. Among PWH in REPRIEVE, a large primary cardiovascular disease prevention cohort, increased PCAT density independently associated with prevalence and severity of coronary plaque, linking increased coronary inflammation to CAD in PWH.",

keywords = "HIV, coronary artery disease, coronary plaque, inflammation, pericoronary adipose tissue",

author = "Borek Foldyna and Thomas Mayrhofer and Zanni, {Markella V.} and Asya Lyass and Radhika Barve and Julia Karady and Sara McCallum and Burdo, {Tricia H.} and Fitch, {Kathleen V.} and Kayla Paradis and Fulda, {Evelynne S.} and Diggs, {Marissa R.} and Bloomfield, {Gerald S.} and Malvestutto, {Carlos D.} and Fichtenbaum, {Carl J.} and Aberg, {Judith A.} and Currier, {Judith S.} and Ribaudo, {Heather J.} and Udo Hoffmann and Lu, {Michael T.} and Douglas, {Pamela S.} and Grinspoon, {Steven K.}",

year = "2023",

month = dec,

day = "15",

doi = "10.1093/cid/ciad419",

language = "English",

volume = "77",

pages = "1676--1686",

journal = "Clinical Infectious Diseases",

issn = "1058-4838",

publisher = "Oxford University Press",

number = "12",

}

Foldyna, B, Mayrhofer, T, Zanni, MV, Lyass, A, Barve, R, Karady, J, McCallum, S, Burdo, TH, Fitch, KV, Paradis, K, Fulda, ES, Diggs, MR, Bloomfield, GS, Malvestutto, CD, Fichtenbaum, CJ, Aberg, JA, Currier, JS, Ribaudo, HJ, Hoffmann, U, Lu, MT, Douglas, PS & Grinspoon, SK 2023, 'Pericoronary Adipose Tissue Density, Inflammation, and Subclinical Coronary Artery Disease Among People With HIV in the REPRIEVE Cohort', Clinical Infectious Diseases, vol. 77, no. 12, pp. 1676-1686. https://doi.org/10.1093/cid/ciad419

TY - JOUR

T1 - Pericoronary Adipose Tissue Density, Inflammation, and Subclinical Coronary Artery Disease Among People With HIV in the REPRIEVE Cohort

AU - Foldyna, Borek

AU - Mayrhofer, Thomas

AU - Zanni, Markella V.

AU - Lyass, Asya

AU - Barve, Radhika

AU - Karady, Julia

AU - McCallum, Sara

AU - Burdo, Tricia H.

AU - Fitch, Kathleen V.

AU - Paradis, Kayla

AU - Fulda, Evelynne S.

AU - Diggs, Marissa R.

AU - Bloomfield, Gerald S.

AU - Malvestutto, Carlos D.

AU - Fichtenbaum, Carl J.

AU - Aberg, Judith A.

AU - Currier, Judith S.

AU - Ribaudo, Heather J.

AU - Hoffmann, Udo

AU - Lu, Michael T.

AU - Douglas, Pamela S.

AU - Grinspoon, Steven K.

PY - 2023/12/15

Y1 - 2023/12/15

N2 - Background. Pericoronary adipose tissue (PCAT) may influence plaque development through inflammatory mechanisms. We assessed PCAT density, as a measure of pericoronary inflammation, in relationship to coronary plaque among people with human immunodeficiency virus (HIV [PWH]) and to a matched control population. Methods. In this baseline analysis of 727 participants of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) Mechanistic Substudy, we related computed tomography–derived PCAT density to presence and extent (Leaman score) of coronary artery disease (CAD), noncalcified plaque, coronary artery calcium (CAC), and vulnerable plaque features using multivariable logistic regression analyses. We further compared the PCAT density between PWH and age, sex, body mass index, CAC score, and statin use–matched controls from the community-based Framingham Heart Study (N = 464), adjusting for relevant clinical covariates. Results. Among 727 REPRIEVE participants (age 50.8 ± 5.8 years; 83.6% [608/727] male), PCAT density was higher in those with (vs without) coronary plaque, noncalcified plaque, CAC >0, vulnerable plaque, and high CAD burden (Leaman score >5) (P < .001 for each comparison). PCAT density related to prevalent coronary plaque (adjusted odds ratio [per 10 HU]: 1.44; 95% confidence interval, 1.22–1.70; P < .001), adjusted for clinical cardiovascular risk factors, body mass index, and systemic immune/inflammatory biomarkers. Similarly, PCAT density related to CAC >0, noncalcified plaque, vulnerable plaque, and Leaman score >5 (all P ≤ .002). PCAT density was greater among REPRIEVE participants versus Framingham Heart Study (−88.2 ± 0.5 HU versus −90.6 ± 0.4 HU; P < .001). Conclusions. Among PWH in REPRIEVE, a large primary cardiovascular disease prevention cohort, increased PCAT density independently associated with prevalence and severity of coronary plaque, linking increased coronary inflammation to CAD in PWH.

AB - Background. Pericoronary adipose tissue (PCAT) may influence plaque development through inflammatory mechanisms. We assessed PCAT density, as a measure of pericoronary inflammation, in relationship to coronary plaque among people with human immunodeficiency virus (HIV [PWH]) and to a matched control population. Methods. In this baseline analysis of 727 participants of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) Mechanistic Substudy, we related computed tomography–derived PCAT density to presence and extent (Leaman score) of coronary artery disease (CAD), noncalcified plaque, coronary artery calcium (CAC), and vulnerable plaque features using multivariable logistic regression analyses. We further compared the PCAT density between PWH and age, sex, body mass index, CAC score, and statin use–matched controls from the community-based Framingham Heart Study (N = 464), adjusting for relevant clinical covariates. Results. Among 727 REPRIEVE participants (age 50.8 ± 5.8 years; 83.6% [608/727] male), PCAT density was higher in those with (vs without) coronary plaque, noncalcified plaque, CAC >0, vulnerable plaque, and high CAD burden (Leaman score >5) (P < .001 for each comparison). PCAT density related to prevalent coronary plaque (adjusted odds ratio [per 10 HU]: 1.44; 95% confidence interval, 1.22–1.70; P < .001), adjusted for clinical cardiovascular risk factors, body mass index, and systemic immune/inflammatory biomarkers. Similarly, PCAT density related to CAC >0, noncalcified plaque, vulnerable plaque, and Leaman score >5 (all P ≤ .002). PCAT density was greater among REPRIEVE participants versus Framingham Heart Study (−88.2 ± 0.5 HU versus −90.6 ± 0.4 HU; P < .001). Conclusions. Among PWH in REPRIEVE, a large primary cardiovascular disease prevention cohort, increased PCAT density independently associated with prevalence and severity of coronary plaque, linking increased coronary inflammation to CAD in PWH.

KW - HIV

KW - coronary artery disease

KW - coronary plaque

KW - inflammation

KW - pericoronary adipose tissue

UR - http://www.scopus.com/inward/record.url?scp=85180011358&partnerID=8YFLogxK

U2 - 10.1093/cid/ciad419

DO - 10.1093/cid/ciad419

M3 - Article

C2 - 37439633

AN - SCOPUS:85180011358

SN - 1058-4838

VL - 77

SP - 1676

EP - 1686

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

IS - 12

ER -

Pericoronary Adipose Tissue Density, Inflammation, and Subclinical Coronary Artery Disease Among People With HIV in the REPRIEVE Cohort

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