Correlations between carotid IMT, factor VIII activity level and metabolic disturbances: a cardio-vascular risk
Luc de Saint Martin1, Elisabeth Pasquier, Olivier Vandhuick
1Brest University Hospital, Brest, France. luc.desaintmartin@chu-brest.fr
Insights
Elevated factor VIII activity in HIV patients correlates with atherosclerosis markers and metabolic syndrome features. This suggests targeting thrombus formation, not just atherosclerosis, is crucial for preventing cardiovascular events during antiretroviral therapy.
Area of Science:
- Cardiovascular Medicine
- Infectious Diseases
- Hematology
Background:
- HIV infection is linked to increased cardiovascular events, potentially exacerbated by antiretroviral therapy (ART).
- A pro-thrombotic state may contribute to atherosclerosis progression in HIV patients on ART.
- Factor VIII (FVIII) activity has been implicated in both arterial and venous thrombosis.
Purpose of the Study:
- To investigate the association between FVIII plasma activity and atherosclerosis in HIV-infected individuals.
- To explore the relationship between FVIII activity, carotid intima-media thickness (CIMT), and metabolic risk factors.
- To determine the role of FVIII as a potential cofactor in ART-induced cardiovascular events.
Main Methods:
- Cross-sectional study of 154 HIV-infected outpatients.
- Measurement of plasma FVIII activity.
- Assessment of CIMT as a surrogate marker for atherosclerosis.
- Evaluation of traditional atherosclerosis risk factors, including blood glucose and triglycerides.
Main Results:
- FVIII plasma activity was significantly associated with CIMT.
- FVIII activity showed a strong correlation with blood glucose and triglyceride levels.
- Raised FVIII activity was identified as a feature of metabolic syndrome in this cohort.
Conclusions:
- Elevated FVIII activity is linked to subclinical atherosclerosis and metabolic abnormalities in HIV patients.
- FVIII may act as a cofactor in the development of cardiovascular events associated with highly active antiretroviral therapy (HAART).
- Preventive strategies for HAART-induced cardiovascular events should consider both atherosclerosis and thrombus formation processes.
Abstract:
In the HIV infection, the short time-scale between the HIV-induced cardiovascular events and the onset of antiretroviral therapy elicits a thrombophilic co-factor that worsens the induced atherosclerosis. We compared the factor VIII plasma activity, previously implicated in arterial and venous thrombosis, with a surrogate marker of atherosclerosis, the carotid intima-media thickness, and with the usual atherosclerosis risk factors in 154 HIV infected outpatients. The FVIII plasma activity is significantly associated with the carotid intima-media thickness and, strongly, with blood glucose and triglycerides levels. A raised FVIII plasma activity is an important feature of the metabolic syndrome and a putative co-factor of HAART induced cardiovascular events. Thus the prevention of the HAART-induced cardio-vascular events should probably not be exclusively focused on atherosclerosis but likewise on the thrombus formation process.
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