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Associations between lipids and subclinical coronary atherosclerosis

Seamus P Whelton1, Jennifer A Deal2, Michelle Zikusoka3

  • 1Division of Cardiology, Department of Medicine, Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine.

AIDS (London, England)
|April 5, 2019
PubMed

Insights

Serum lipids are linked to coronary atherosclerosis in both HIV-infected and HIV-uninfected men. However, these associations are weaker in HIV-infected individuals, potentially impacting cardiovascular disease risk assessment.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases (HIV/AIDS)

Background:

  • The relationship between serum lipids and coronary atherosclerosis in individuals with human immunodeficiency virus (HIV) is not fully understood.
  • Understanding these associations is crucial for accurate cardiovascular disease (CVD) risk stratification in HIV-positive populations.

Purpose of the Study:

  • To investigate how HIV infection modifies the association between traditional serum lipid levels and coronary atherosclerosis.
  • To examine the relationship between lipids and coronary plaque subtypes in HIV-infected (HIV+) versus HIV-uninfected (HIV-) men.

Main Methods:

  • Analysis of data from the Multicenter AIDS Cohort Study, including 429 HIV+ and 303 HIV- men.
  • Utilized cardiac computed tomography (CCT) and coronary computed tomography angiography (CCTA) to assess coronary artery calcium, stenosis, and plaque composition.
  • Employed multivariable adjusted prevalence ratios to evaluate lipid parameter associations with coronary atherosclerosis.

Main Results:

  • Total cholesterol (TC)/HDL-cholesterol ratio showed the strongest association with coronary atherosclerosis in both HIV+ and HIV- men.
  • Lipid parameters were most significantly linked to mixed plaque, >50% stenosis, and coronary artery calcium in both groups.
  • Associations between lipids and coronary atherosclerosis were consistently weaker in HIV+ men compared to HIV- men.

Conclusions:

  • While TC/HDL-cholesterol remains a key predictor, the overall weaker association between lipids and coronary atherosclerosis in HIV+ individuals may explain reduced CVD risk discrimination.
  • These findings highlight potential differences in lipid metabolism and vascular disease pathogenesis in the context of HIV infection.
Abstract

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