title: Small dense lipoproteins, apolipoprotein B, and risk of coronary events in HIV-infected patients on antiretroviral therapy: the Swiss HIV Cohort Study.
abstract: OBJECTIVE
  HIV infection and exposure to certain antiretroviral drugs is associated with dyslipidemia and increased risk for coronary events. Whether this risk is mediated by highly atherogenic lipoproteins is unclear. We investigated the association of highly atherogenic small dense low-density lipoproteins (LDLs) and apolipoprotein B and coronary events in HIV-infected individuals receiving antiretroviral therapy.
  
  
  METHODS
  We conducted a case-control study nested into the Swiss HIV Cohort Study to investigate the association of small dense LDL and apolipoprotein B and coronary events in 98 antiretroviral drug-treated patients with a first coronary event (19 fatal and 79 nonfatal coronary events with 53 definite and 15 possible myocardial infarctions, 11 angioplasties or bypasses) and 393 treated controls matched for age, gender, and smoking status. Lipids were measured by ultracentrifugation.
  
  
  RESULTS
  In models including cholesterol, triglycerides, high-density lipoprotein cholesterol, blood pressure, central obesity, diabetes, and family history, there was an independent association between small dense LDL and coronary events [odds ratio (OR) for 1 mg/dL increase: 1.06, 95% confidence interval (CI): 1.00 to 1.11] and apolipoprotein B (OR for 10 mg/dL increase: 1.16, 95% CI: 1.02 to 1.32). When adding HIV and antiretroviral therapy-related variables, ORs were 1.04 (95% CI: 0.99 to 1.10) for small dense LDL and 1.13 (95% CI: 0.99 to 1.30) for apolipoprotein B. In both models, blood pressure and HIV viral load was independently associated with the odds for coronary events.
  
  
  CONCLUSIONS
  HIV-infected patients receiving antiretroviral therapy with elevate small dense LDL and apolipoprotein B are at increased risk for coronary events as are patients without sustained HIV suppression.
authors.affiliation: Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Switzerland. hbucher@uhbs.ch
authors.forename: Heiner C
authors.initials: HC
authors.lastname: Bucher
authors.forename: Werner
authors.initials: W
authors.lastname: Richter
authors.forename: Tracy R
authors.initials: TR
authors.lastname: Glass
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Magenta
authors.forename: Qing
authors.initials: Q
authors.lastname: Wang
authors.forename: Matthias
authors.initials: M
authors.lastname: Cavassini
authors.forename: Pietro
authors.initials: P
authors.lastname: Vernazza
authors.forename: Bernard
authors.initials: B
authors.lastname: Hirschel
authors.forename: Rainer
authors.initials: R
authors.lastname: Weber
authors.forename: Hansjakob
authors.initials: H
authors.lastname: Furrer
authors.forename: Manuel
authors.initials: M
authors.lastname: Battegay
authors.forename: Enos
authors.initials: E
authors.lastname: Bernasconi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D001055:Apolipoproteins B / Q000097:blood*; D016022:Case-Control Studies; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D001055:Apolipoproteins B; D008077:Lipoproteins, LDL