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Association of Lipoprotein(a) with peri-coronary inflammation in persons with and without HIV infection
Erin Zisman1, Mian Hossain2, Nicholas T Funderburg3
1University of Maryland School of Medicine, Department of Medicine, Baltimore, MD, USA (Dr Zisman).
Insights
Lipoprotein(a) [Lp(a)] is linked to increased peri-coronary inflammation in individuals with human immunodeficiency virus (HIV). This finding highlights Lp(a) as a potential factor in cardiovascular disease risk for PWH.
Area of Science:
- Cardiology
- Immunology
- HIV Research
Background:
- Individuals with human immunodeficiency virus (HIV) face a higher risk of cardiovascular disease (CVD) compared to those without HIV.
- Lipoprotein(a) [Lp(a)] is a recognized risk factor for atherosclerosis in the general population.
- The relationship between Lp(a) and peri-coronary inflammation in people with HIV (PWH) has not been previously studied.
Purpose of the Study:
- To determine if Lp(a) is associated with peri-coronary inflammation, assessed by the fat attenuation index (FAI).
- To investigate the link between Lp(a) and activated monocytes and T lymphocytes in PWH and persons without HIV (PWoH).
Main Methods:
- Plasma Lp(a) levels were measured in 58 PWH and 21 PWoH without prevalent CVD who had FAI measurements.
- Multivariable regression models were used to assess the association of Lp(a) with FAI values in the right coronary artery (RCA) and left anterior descending artery.
- Correlations between Lp(a) levels and systemic inflammatory markers and immune cell subsets were examined.
Main Results:
- Lp(a) showed a significant association with greater peri-coronary inflammation in the RCA among PWH compared to PWoH (β=1.73, P=0.019) in adjusted models.
- Lp(a) levels correlated significantly with specific inflammatory markers including tumor necrosis factor receptor-I and -II, and high-sensitivity C-reactive protein.
- Associations were found between Lp(a) and markers of monocyte activation (CD16-CD163+, CD16-DR+ MFI) and a T cell subset (CD38+CD4+ TEMRA).
Conclusions:
- Lp(a) is associated with increased peri-coronary inflammation in the RCA of PWH compared to PWoH.
- Lp(a) also correlates with specific systemic inflammatory markers and immune cell subsets in the peripheral circulation of PWH.
Background:
Persons with human immunodeficiency virus (HIV) (PWH) have an increased risk of developing cardiovascular disease (CVD) compared to persons without HIV (PWoH). Lipoprotein(a) [Lp(a)] is a known atherosclerotic risk factor in PWoH, but there are no studies investigating Lp(a) and peri-coronary inflammation.
Objective:
To investigate whether Lp(a) is associated with peri-coronary inflammation as assessed by the fat attenuation index (FAI) and activated monocytes and T lymphocytes in PWH and PWoH.
Methods:
We measured plasma levels of Lp(a) at study entry in 58 PWH and 21 PWoH without CVD and who had FAI measurements. Associations of Lp(a) with FAI values of the right coronary artery (RCA) and left anterior descending artery were evaluated using multivariable regression models adjusted for potential confounders. Correlations between Lp(a) levels and systemic inflammatory markers and immune cell subsets were examined.
Results:
Lp(a) was associated with greater peri-coronary inflammation among PWH compared to PWoH (β=1.73, P=0.019) in the RCA, in adjusted models. Significant correlations were observed with certain inflammatory markers (tumor necrosis factor receptor [TNFR]-I, b=0.295, P<0.001; TNFR-II, b=0.270, P=0.002; high-sensitivity C-reactive protein, b=0.195, P=0.028). Significant correlations were found between Lp(a) levels and several markers of monocyte activation: CD16 -CD163+ (b= -0.199, P=0.024), and CD16 -DR+ MFI (b= -0.179, P=0.042) and T cell subset CD38+CD4+ TEMRA (b= 0.177, P= 0.044).
Conclusions:
Lp(a) was associated with greater peri-coronary inflammation in the RCA in PWH compared to PWoH, as well as with select systemic inflammatory markers and specific subsets of immune cells in peripheral circulation.
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