[Cystatin C: Biomarker of cardiovascular risk in HIV]
A M Ghelfi1, M R Galván2, F Fay3
1Servicio de Clínica Médica, Hospital Escuela Eva Perón, Granadero Baigorria, Santa Fe, Argentina.
Insights
Cystatin C (CC) levels ≥0.95mg/L are linked to cardiovascular disease (CVD) in people with HIV. This marker also indicates higher blood pressure and 10-year cardiovascular risk in this population.
Area of Science:
- Cardiology
- Infectious Diseases
- Biochemistry
Background:
- Human immunodeficiency virus (HIV) infection elevates cardiovascular risk (CVR).
- CVD development in HIV+ individuals involves traditional risk factors, infection-related inflammation, immune dysfunction, and antiretroviral therapy.
- Cystatin C (CC) is a marker for CVR and CVD in general, elderly, and chronic kidney disease populations.
Purpose of the Study:
- To analyze the association between Cystatin C (CC) and cardiovascular disease (CVD) in HIV-positive (HIV+) individuals.
- To determine if CC is an independent predictor of CVD in the HIV+ population.
Main Methods:
- An observational, cross-sectional study included 95 HIV+ patients.
- Patients were categorized into high CC (≥0.95mg/L) and normal CC (<0.95mg/L) groups.
- Data collected included CVR factors, CVD status, and CC levels.
Main Results:
- A CC level of ≥0.95mg/L was significantly associated with the presence of CVD (P=.01).
- High CC correlated with increased waist and neck circumference, systolic and diastolic blood pressure, and Framingham CVR scores.
- Multivariate analysis confirmed CC ≥0.95mg/L as an independent predictor of CVD in HIV+ patients.
Conclusions:
- Elevated Cystatin C (≥0.95mg/L) is independently associated with cardiovascular disease in HIV-positive individuals.
- This CC threshold also indicates higher blood pressure and 10-year cardiovascular risk, per Framingham scores.
- CC may serve as a valuable biomarker for assessing CVD risk in the HIV+ population.
Introduction:
Patients infected with the human immunodeficiency virus (HIV) have a higher cardiovascular risk (CVR). The development of cardiovascular disease (CVD) in this population involves traditional CVR factors and factors related to the infection itself, such as chronic inflammatory status, immune dysfunction, as well as the antiretroviral therapy received. Cystatin C (CC) has shown to be useful in assessing the presence of CVR factors and CVD established in the general population, the elderly population, and patients with chronic kidney disease. An analysis was performed on this association in an HIV positive population (HIV+).
Material And Methods:
Analytical, observational, cross-sectional study was conducted, and included collecting information about CVR factors and CVD in HIV+, as well as measuring CC. The patients were divided into 2 groups: Group1=high CC (≥0.95mg/L) and Group2=normal CC (<0.95mg/L).
Results:
A total of 95 patients were included. Group1=27 (28.4%) and Group2=68 (71.5%). A value of CC≥0.95mg/L was related to the presence of CVD (P=.01). It was also related with and an increase in waist circumference (P=.05), neck circumference (P=.04), systolic blood pressure (P=.04), diastolic blood pressure (P=.01), Framingham score (P=.03), and Framingham score adapted for HIV (P=.01). After performing multivariate analysis with incorporation of variables associated with CVD in the bivariate analysis, only CC≥0.95mg/L continued to be related to CVD.
Conclusion:
CC≥0.95mg/L was independently associated with CVD. This cut-off point was also linked to higher levels of blood pressure, and higher CVR at 10 years using the Framingham Score and Framingham Score adapted for HIV population.
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