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Session 102 Poster Abstracts
Cardiovascular Complications: Risk Factors, Incidence, Prevalence, and Outcomes
Tuesday, 1:30 - 3:30 pm
Poster Hall


738    
Risk Factors for Cardiovascular Disease, Common, and Internal Carotid Artery Intima-Media Thickness and Coronary Calcium Scores in a Cohort of HIV-infected Subjects from Nutrition for Healthy Living
A Mangili*1,2, J Gerrior1, A Tang1, D H O'Leary1,2, J F Polack1,2, E J Schaefer1,2, S L Gorbach1,2, and C A Wanke1,2
1Tufts Univ. Sch. of Med., Boston, MA, USA and 2Tufts-New England Med. Ctr., Boston, MA, USA

Background:  There is concern for increased risk of cardiovascular events in HIV infection. We evaluated risk factors for cardiovascular disease using carotid IMT and CCS as surrogate markers in HIV-infected adults, from a longitudinal study examining nutritional and metabolic parameters.

Methods:  Cross-sectional analysis in NFHL participants with carotid IMT (n = 230) and CCS (n = 239). Kruskal-Wallis tests and Spearman’s correlation coefficients were calculated.

Results:  Of the total, 51 (22%) were female, 57 (25%) were not on HAART, 113 (49.1%) smoked, 19 (8.3%) had IDU history. Overall, mean age was 45 years (±7.1), BP 118/76 (± 16/10), BMI 26 (±5), total cholesterol (TC) 192 (± 60), triglycerides (TG) 234 (±578), CD4 456 (± 309), log HIV RNA 3.1 (± 1.07). For CCA, 16 (7%) had IMT >0.8 mm; for ICA, 56 (24%) had IMT >0.8 mm. For CCS, 73 (30%) had a score of 0 to 10, 40 (17%) of 10 to 100, 21 (9%) of >100. TG, TC, ApoB, ApoE, and RLPC were significantly higher in men on HAART and TC in women on HAART (p <0.05). IMT and CCS were not significantly different by HAART use (p >0.05); 7 to 26% had abnormal surrogate markers of cardiovascular disease. Of note, duration of HIV infection was correlated overall with CCA IMT and there was a trend for CD4 correlation with CCS in men. Otherwise, traditional cardiovascular disease risk factors, age, SBP, and ApoB were correlated with CCA IMT in both sexes and CCS in men only. Waist was correlated with CCA IMT in men. Insulin resistance and TG were correlated with CCS in women and there was a trend for correlation with BMI. CRP was correlated with CCA IMT and CCS in women. Results for ICA were similar to CCA. 

 

Correlation Coefficients

 

Men

Women

Men

Women

Variable

CCA IMT

p

CCA IMT

p

CCS

p

CCS

p

 

Age

0.46

0.00

0.53

0.00

0.32

0.000

0.20

0.144

 

BMI

0.25

0.00

0.24

0.09

-0.06

0.421

0.25

0.067

 

SBP

0.18

0.02

0.40

0.00

0.14

0.068

.019

0.161

 

DBP

0.11

0.14

0.35

0.01

0.06

0.408

0.16

0.241

 

CD4

0.05

0.50

0.15

0.28

-0.14

0.058

0.14

0.306

 

Log HIV RNA

-0.03

0.74

0.09

0.55

0.02

0.777

-0.11

0.418

 

Years HIV

0.13

0.08

0.26

0.06

0.05

0.494

-0.05

0.721

 

Waist

0.30

0.00

0.22

0.12

0.04

0.570

0.32

0.019

 

QUICKI

-0.11

0.15

-0.04

0.80

-0.05

0.504

-0.38

0.005

 

TG

0.10

0.19

0.05

0.74

0.17

0.023

0.34

0.016

 

TC

0.07

0.38

0.11

0.46

0.14

0.065

0.06

0.686

 

LDL

-0.01

0.90

0.01

0.96

0.05

0.522

-0.10

0.477

 

HDL

0.02

0.77

0.23

0.11

-0.09

0.257

0.06

0.701

 

ApoB

0.15

0.04

-0.03

0.86

0.25

0.001

0.05

0.717

 

ApoA-I

-0.01

0.92

0.24

0.09

-0.07

0.325

0.20

0.158

 

ApoE

0.12

0.12

0.06

0.67

0.14

0.058

0.04

0.800

 

RLPC

0.07

0.39

0.08

0.32

0.18

0.016

0.28

0.042

 

CRP

0.01

0.88

0.33

0.02

0.07

0.369

0.42

0.002

 

Hcy

0.07

0.39

0.02

0.91

-0.03

0.701

0.37

0.008

 

Lp(a)

0.22

0.04

0.24

0.25

0.08

0.430

-0.24

0.241

 

 

Conclusions:  Lipid values were higher for men on HAART, but these do not yet correlate with surrogate markers of cardiovascular disease in this population. Although the significant correlations with IMT and CCS were primarily traditional risk factors, some HIV-specific factors are also observed and may become more evident with prolonged HIV infection and treatment.

 

 

 

Keywords: cardiovascular disease; HAART; coronary calcium score