维他命对艾滋病毒感染者的冠状周脂肪组织密度的影响:来自REPRIEVE试验的见解
Borek Foldyna1, Ibrahim Hadzic1, Thomas Mayrhofer2
1Cardiovascular Imaging Research Center, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
JACC. Cardiovascular imaging
|December 1, 2025
概括
冠状周脂肪组织 (PCAT) 密度在艾滋病毒感染者 (PWH) 中增加,但他类药物治疗可以在高危人群中预防这种情况. 增加PCAT密度与死亡率有关,建议将其用作预后生物标志物.
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
- 药理学 药理学是指药理学的学科.
背景情况:
- 周冠状腺脂肪组织 (PCAT) 和其在艾滋病毒 (PWH) 感染者心血管疾病进展中的作用尚不清楚.
- 斯坦丁治疗对PCAT的影响及其与PWH斑块发育的关联需要进一步调查.
研究的目的:
- 为了评估PCAT密度随时间的变化.
- 为了确定他类药物治疗对PCAT的影响.
- 探索PCAT变化,冠状动脉斑块和PWH的临床结果之间的关系.
主要方法:
- 利用了来自REPRIEVE (预防艾滋病毒血管事件的随机试验) CT子研究 (n=753) 的数据.
- 从基线和2年后的非对比CT测量PCAT密度;从对比增强CT血管图评估冠状动脉斑块体积.
- 分析了由冠状动脉疾病负担分层的关联,调整风险因素和他类药物分配.
主要成果:
- 在两年内,PCAT密度增加了4.5个小时,但皮塔瓦斯塔丁在冠状动脉疾病负担较高的参与者中阻止了这种增加 (细分参与得分≥4).
- 较高的PCAT密度与增加的非化斑块体积和减少化斑块进展相关.
- 基线PCAT密度与所有原因死亡率独立相关 (HR每+10 HU:1.95;P=0.040).
结论:
- 在PWH中,PCAT密度随着时间的推移而增加,而皮塔瓦斯塔丁在高危人群中减轻了这种影响.
- PCAT密度与易受损伤的斑块特征和所有原因的死亡率有关.
- PCAT密度显示出作为PWH的预后成像生物标志物的潜力.
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