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冠状动脉斑在艾滋病毒感染者与非艾滋病毒感染者无症状社区和症状较高风险人群中的冠状动脉斑

Julia Karady^1,2, Michael T Lu¹, Göran Bergström^3,4

¹Cardiovascular Imaging Research Center, Massachusetts General Hospital & Harvard Medical School, Boston, Massachusetts, USA.

|June 28, 2024

概括

艾滋病毒感染者 (PWH) 的冠状动脉斑块负担比没有艾滋病毒感染者 (PwoH) 高,即使无症状. 冠状动脉 (CAC) 值为零并不可靠地排除PWH中的斑块.

科学领域:

心血管成像 - 心血管成像
艾滋病毒研究艾滋病毒研究
公共卫生公共卫生

背景情况:

艾滋病毒感染者 (PWH) 呈现出大量的冠状动脉斑块.
与未知艾滋病毒感染者 (PwoH) 进行直接比较需要进一步澄清.

研究的目的:

确定和比较PWH和PwoH之间的冠状动脉斑块负担和表型.
调查不同心血管风险层中的斑块患病率.

主要方法:

分析了来自三个队伍的冠状动脉CT扫描:REPRIEVE (PWH,n=755),SCAPIS (无症状PwoH,n=23,558) 和PROMISE (胸痛PwoH,n=2,291).这些队伍中的每一个患者的肺部CT扫描都被分析了.
通过10年的动脉样硬化心血管疾病 (ASCVD) 风险,年龄和冠状动脉 (CAC) 存在来分层比较.
参与者是没有已知的冠状动脉斑块的非他类药物使用者.

主要成果:

在REPRIEVE中的PWH较年轻,ASCVD风险低于SCAPIS和PROMISE中的PwoH.
与无症状PwoH队列相比,PWH显示冠状动脉斑块的患病率更高 (48.5%对40.3%).
PWH比SCAPIS PwoH有更多的斑块,以及与PROMISE PwoH相似的斑块患病率,即使ASCVD风险较低.
虽然PWH中CAC=0的病例较多,但PWH中的斑块在这个子组中更为普遍 (20.8%对5.4%在SCAPIS中和12.3%在PROMISE中).

结论:

无症状的PWH比无症状的PwoH有更大的斑块负担.
在PWH中冠状动脉斑块的患病率与风险较高的PwoH队列相比,尽管计算的ASCVD风险较低.
冠状动脉 (CAC) 评分为零并不可靠地排除艾滋病毒感染者冠状动脉斑块的存在.

关键词:

无症状的社区队列心血管疾病心血管疾病冠状动脉CT动脉图.冠状动脉斑块是一种冠状动脉斑块.感染艾滋病毒的人.稳定的胸部疼痛稳定的胸部疼痛

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