HIV infection is associated with an increased prevalence of coronary noncalcified plaque among participants with a coronary artery calcium score of zero: Multicenter AIDS Cohort Study (MACS).
OBJECTIVES
HIV-infected individuals bear increased cardiovascular risk even in the absence of traditional cardiovascular risk factors. In the general population, coronary artery calcium (CAC) scanning is of value for cardiovascular risk stratification, but whether a CAC score of zero implies a low noncalcified coronary plaque burden in HIV-infected persons is unknown.


METHODS
We assessed the prevalence of noncalcified coronary plaque and compared noncalcified coronary plaque burden between HIV-infected and HIV-uninfected participants who had CAC scores of zero in the Multicenter AIDS Cohort Study (MACS) using coronary computed tomography (CT) angiography.


RESULTS
HIV infection was associated with the presence of noncalcified coronary plaque among these men with CAC scores of zero. In a model adjusted only for age, race, centre, and pre- or post-2001 cohort, the prevalence ratio for the presence of noncalcified plaque was 1.27 (95% confidence interval 1.04-1.56; P = 0.02). After additionally adjusting for cardiovascular risk factors, HIV infection remained associated with the presence of noncalcified coronary plaque (prevalence ratio 1.31; 95% confidence interval 1.07-1.6; P = 0.01).


CONCLUSIONS
Among men with CAC scores of zero, HIV infection is associated with an increased prevalence of noncalcified coronary plaque independent of traditional cardiovascular risk factors. This finding suggests that CAC scanning may underestimate plaque burden in HIV-infected men.
['Metkus|T S|TS|', 'Brown|T|T|', 'Budoff|M|M|', 'Kingsley|L|L|', 'Palella|F J|FJ|', 'Witt|M D|MD|', 'Li|X|X|', 'George|R T|RT|', 'Jacobson|L P|LP|', 'Post|W S|WS|']
D000328:Adult D002114:Calcinosis D003324:Coronary Artery Disease D005260:Female D015658:HIV Infections D006801:Humans D008297:Male D008875:Middle Aged D058226:Plaque, Atherosclerotic D015995:Prevalence D011446:Prospective Studies D012307:Risk Factors D014057:Tomography, X-Ray Computed
coronary artery calcium score coronary disease risk stratificiation