title: HIV and coronary arterial remodeling from the Multicenter AIDS Cohort Study (MACS).
abstract: OBJECTIVE
  Positive remodeling (PR), a coronary artery characteristic associated with risk for myocardial infarction (MI), may be more prevalent in HIV-infected (HIV+) people. We evaluated the prevalence of PR using coronary CT angiography (CCTA) in HIV+ and HIV-uninfected (HIV-) men.
  
  
  METHODS
  Men enrolled in the Multicenter AIDS Cohort Study underwent CCTA if they were 40-70 years, had normal kidney function and no history of coronary revascularization. Multivariable logistic regression models were used to estimate the odds ratio (OR) of PR by HIV serostatus, adjusting for demographics and coronary artery disease (CAD) risk factors. Analysis of PR among atherosclerotic segments further adjusted for plaque type and stenosis.
  
  
  RESULTS
  The prevalence of PR was 8.4% versus 12.1% (p = 0.10) for HIV- and HIV + men, respectively. After demographic adjustment, HIV + men had twice the odds of PR [OR 2.01(95% CI 1.20-3.38)], which persisted after CAD risk factor adjustment [1.76(1.00-3.10)]. Higher systolic blood pressure, total cholesterol, diabetes medication use, older age, segment number with plaque present, mixed and non-calcified plaque, and stenosis>50%, were associated with increased odds of PR, while higher HDL cholesterol, higher nadir CD4 count, and black race were associated with lower PR odds. Among atherosclerotic segments, the association between HIV infection and PR persisted, but was not statistically significantly.
  
  
  CONCLUSIONS
  HIV+ men have more positively remodeled arterial segments, which may be due to more coronary segments with atherosclerosis or HIV-related immunosuppression. Further studies are needed to evaluate whether PR contributes to higher rates of MI in HIV+ individuals.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore MD, USA.
authors.forename: P Elliott
authors.initials: PE
authors.lastname: Miller
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Sabina A
authors.initials: SA
authors.lastname: Haberlen
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore MD, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Metkus
authors.affiliation: Harbor-UCLA, Torrence, CA, USA.
authors.forename: Panteha
authors.initials: P
authors.lastname: Rezaeian
authors.affiliation: Northwestern University, Chicago, IL, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Palella
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Kingsley
authors.affiliation: Harbor-UCLA, Torrence, CA, USA.
authors.forename: Mallory D
authors.initials: MD
authors.lastname: Witt
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore MD, USA.
authors.forename: Richard T
authors.initials: RT
authors.lastname: George
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Jacobson
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore MD, USA.
authors.forename: Todd T
authors.initials: TT
authors.lastname: Brown
authors.affiliation: Harbor-UCLA, Torrence, CA, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Budoff
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore MD, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: wpost@jhmi.edu.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000368:Aged; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications; D003331:Coronary Vessels / Q000473:pathology*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications*; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic / Q000473:pathology; D012307:Risk Factors; D013599:Systole
chemical_list: D002784:Cholesterol
keywords: AIDS; Coronary disease; Epidemiology; Imaging