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Significant coronary stenosis detected by coronary computed angiography in asymptomatic HIV infected subjects

Gabriella d'Ettorre1, Marco Francone, Massimo Mancone

  • 1Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy.

The Journal of Infection
|October 11, 2011
PubMed

Insights

Coronary artery disease (CAD) screening in HIV patients revealed a high rate of significant coronary stenosis in asymptomatic individuals with low cardiovascular risk. Age was a key factor, suggesting tailored screening for this population.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Radiology

Background:

  • HIV infection is associated with increased cardiovascular events and atherosclerosis.
  • Traditional cardiovascular risk scores may underestimate CAD risk in HIV-positive individuals.
  • Limited data exists on subclinical coronary artery disease (CAD) in HIV patients with low traditional risk.

Purpose of the Study:

  • To investigate the prevalence of significant coronary stenosis in asymptomatic HIV-infected individuals with low cardiovascular risk.
  • To assess the utility of cardiac CT scan in evaluating CAD in this specific population.
  • To identify factors associated with coronary artery disease in HIV patients.

Main Methods:

  • A cross-sectional study utilized dual-source multi-detector CT (MDCT) coronary angiography.
  • Participants were HIV-infected subjects with a Framingham Risk Score ≤10 and no metabolic syndrome or abnormal stress tests.
  • Significant coronary stenosis was defined as luminal narrowing >50%; calcium scoring was performed.

Main Results:

  • 16 out of 55 (29.1%) asymptomatic HIV-positive subjects had significant coronary stenoses.
  • Older age was the only independent predictor of significant luminal narrowing (p=0.011).
  • This finding was unexpected given the low traditional cardiovascular risk profile of the cohort.

Conclusions:

  • MDCT identified a high, age-associated prevalence of significant coronary stenosis in low-risk, asymptomatic HIV-positive individuals.
  • Findings suggest that aggressive CAD screening may be warranted in this population.
  • Further research is recommended to confirm the role of MDCT in HIV-associated CAD screening.
Abstract

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