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Elevated cardiovascular risk in people with HIV: the association with coronary artery calcification and endothelial
Anas Ismail1, Idris Garba2, Abbas Rabiu Muhammad1
1Department of Radiology.
Insights
People with HIV (PWH) in Nigeria have a significantly higher burden of coronary artery disease (CAD) than HIV-negative individuals. This increased cardiovascular risk in PWH necessitates integrated screening and prevention into HIV care.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Coronary artery disease (CAD) poses a significant health challenge globally.
- People with HIV (PWH) may experience accelerated cardiovascular disease due to factors like chronic inflammation and antiretroviral therapy (ART).
- Understanding CAD burden in PWH in specific regions like northern Nigeria is crucial for targeted interventions.
Purpose of the Study:
- To evaluate the prevalence, severity, and patterns of CAD in people with HIV (PWH).
- To investigate the association between CAD and metabolic syndrome, inflammation, and endothelial dysfunction in PWH.
- To compare cardiovascular risk factors between PWH and HIV-negative individuals.
Main Methods:
- A comparative cross-sectional study involving 72 PWH and 72 matched HIV-negative controls.
- Assessment included demographics, metabolic parameters, viral load, brachial artery flow-mediated dilation (BAFMD), and coronary artery calcification (CAC) scores.
- Statistical analyses utilized t-tests, linear regression, and Chi-squared/Fisher's exact tests.
Main Results:
- PWH exhibited a substantially higher prevalence of CAD (31.9% vs. 4.2%) and mean CAC scores (23.2 vs. 2.7) compared to controls.
- CAD in PWH was linked to longer ART duration, higher BMI, and reduced BAFMD.
- High-sensitivity C-reactive protein (hsCRP) was identified as a predictor of CAD in the control group.
Conclusions:
- People with HIV in northern Nigeria face a greater burden of CAD, characterized by increased CAC and endothelial dysfunction, irrespective of viral load.
- These findings underscore the critical need for integrating routine cardiovascular screening and prevention strategies into HIV care protocols.
- Early detection and management of cardiovascular risk factors are essential for improving long-term outcomes in PWH.
Objective:
This study aimed to assess the burden, severity, and pattern of coronary artery disease (CAD) in people with HIV (PWH), as well as its relationship with metabolic syndrome, inflammation, and endothelial dysfunction.
Design:
Cross-sectional study.
Methods:
A comparative cross-sectional study was conducted on 72 PWH and 72 matched people without HIV at Aminu Kano Teaching Hospital (AKTH), in Kano, northern Nigeria. Data collection included demographics, metabolic parameters, viral load, brachial artery flow-mediated dilation (BAFMD) assessed via ultrasound, and coronary artery calcification (CAC) scores obtained using electrocardiogram (ECG)-gated computed tomography. CAD predictors were analyzed using t tests, linear regression, and chi-squared/Fisher's exact tests ( P ≤ 0.05).
Results:
Among 144 participants (72 PWH, 72 controls), PWH had higher CAD prevalence (31.9 vs. 4.2%, P < 0.001) and mean CAC scores (23.2 vs. 2.7, P < 0.001). CAD was significantly associated with longer ART duration ( P = 0.04), higher BMI ( P = 0.005), and reduced BAFMD ( P = 0.020). In controls, hs-CRP predicted CAD ( P = 0.004).
Conclusion:
PWH in northern Nigeria have a higher burden of CAD compared to HIV-negative controls, with greater CAC and endothelial dysfunction, independent of viral load status. These findings highlight the need for routine cardiovascular screening and integration of cardiovascular disease prevention into HIV care.
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