title: Elevated D-dimer is independently associated with endothelial dysfunction: a cross-sectional study in HIV-infected adults on antiretroviral therapy.
abstract: BACKGROUND
  D-Dimer elevations have been associated with a striking increase in mortality in HIV-infected patients. However, D-Dimer has not been directly linked to endothelial dysfunction in HIV.
  
  
  METHODS
  In this cross-sectional study, we used flow-mediated dilation (FMD) of the brachial artery to measure endothelial function and several biomarkers to measure systemic inflammation and coagulation activation in HIV-infected adults on stable antiretroviral therapy with HIV-1 RNA levels <400 copies/ml. Multivariable linear regression was used to model FMD by these markers, traditional cardiovascular risk factors and HIV-related characteristics.
  
  
  RESULTS
  Analysis included 98 subjects (88% male, median age 47.5 years, CD4(+) T-cells 578.5 cells/mm(3)); all on ART (52% on protease inhibitors). The only factors independently associated with FMD were D-Dimer and body mass index.
  
  
  CONCLUSIONS
  We show for the first time an independent association between D-Dimer and endothelial dysfunction in virologically suppressed, HIV-infected adults on stable antiretroviral therapy, potentially explaining the link between D-Dimer and mortality in HIV.
authors.affiliation: MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Corrilynn O
authors.initials: CO
authors.lastname: Hileman
authors.forename: Chris T
authors.initials: CT
authors.lastname: Longenecker
authors.forename: Teresa L
authors.initials: TL
authors.lastname: Carman
authors.forename: Ginger L
authors.initials: GL
authors.lastname: Milne
authors.forename: Danielle E
authors.initials: DE
authors.lastname: Labbato
authors.forename: Norma J
authors.initials: NJ
authors.lastname: Storer
authors.forename: Cynthia A
authors.initials: CA
authors.lastname: White
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D018791:CD4 Lymphocyte Count; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000378:metabolism / Q000473:pathology; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D015658:HIV Infections / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D017320:HIV Protease Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D015497:HIV-1 / Q000472:pathogenicity; D006801:Humans; D007249:Inflammation / Q000473:pathology; D015850:Interleukin-6 / Q000097:blood; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D014463:Ultrasonography; D014664:Vasodilation
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D017320:HIV Protease Inhibitors; C508600:IL6 protein, human; D015850:Interleukin-6; D012367:RNA, Viral; C036309:fibrin fragment D