title: Associations between Tobacco, Alcohol, and Drug Use with Coronary Artery Plaque among HIV-Infected and Uninfected Men in the Multicenter AIDS Cohort Study.
abstract: BACKGROUND
  We characterized associations between smoking, alcohol, and recreational drug use and coronary plaque by HIV serostatus within the Multicenter AIDS Cohort Study (MACS).
  
  
  METHODS
  MACS participants (N = 1005, 621 HIV+ and 384 HIV-) underwent non-contrast CT scanning to measure coronary artery calcium; 764 underwent coronary CT angiograms to evaluate plaque type and extent. Self-reported use of alcohol, tobacco, smoked/inhaled cocaine, methamphetamine, ecstasy, marijuana, inhaled nitrites, and erectile dysfunction drugs was obtained at semi-annual visits beginning 10 years prior to CT scanning. Multivariable logistic and linear regression models were performed, stratified by HIV serostatus.
  
  
  RESULTS
  Among HIV+ men, current smoking, former smoking, and cumulative pack years of smoking were positively associated with multiple coronary plaque measures (coronary artery calcium presence and extent, total plaque presence and extent, calcified plaque presence, and stenosis >50%). Smoking was significantly associated with fewer plaque measures of comparable effect size among HIV- men; current smoking and calcified plaque extent was the only such association. Heavy alcohol use (>14 drinks/week) was associated with stenosis >50% among HIV+ men. Among HIV- men, low/moderate (1-14 drinks/week) and heavy alcohol use were inversely associated with coronary artery calcium and calcified plaque extent. Few significant associations between other recreational drug use and plaque measures were observed.
  
  
  CONCLUSIONS
  Smoking is strongly associated with coronary plaque among HIV+ men, underscoring the value of smoking cessation for HIV+ persons. Alcohol use may protect against coronary artery calcium and calcified plaque progression in HIV- (but not HIV+) men. Few positive associations were observed between recreational drug use and coronary plaque measures.
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America.
authors.forename: Sean G
authors.initials: SG
authors.lastname: Kelly
authors.affiliation: Georgetown University, Washington, D. C., United States of America.
authors.forename: Michael
authors.initials: M
authors.lastname: Plankey
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.|Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Xiuhong
authors.initials: X
authors.lastname: Li
authors.affiliation: University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Ronald
authors.initials: R
authors.lastname: Stall
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Jacobson
authors.affiliation: Harbor-UCLA Medical Center, Torrance, California‎, United States of America.
authors.forename: Mallory D
authors.initials: MD
authors.lastname: Witt
authors.affiliation: University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States of America.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Kingsley
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
authors.forename: Christopher
authors.initials: C
authors.lastname: Cox
authors.affiliation: Harbor-UCLA Medical Center, Torrance, California‎, United States of America.
authors.forename: Matthew
authors.initials: M
authors.lastname: Budoff
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Palella
mesh_terms: D000428:Alcohol Drinking; D015331:Cohort Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D019966:Substance-Related Disorders / Q000150:complications*; D014057:Tomography, X-Ray Computed
references.citation: Am J Cardiol. 2002 Aug 1;90(3):326-8
references.pmid: 12127624
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1998 Nov 1;19(3):266-73
references.pmid: 9803969
references.citation: Int J Cardiol. 2003 Apr;88(2-3):191-8
references.pmid: 12714198
references.citation: N Engl J Med. 2003 Jan 9;348(2):109-18
references.pmid: 12519921
references.citation: Arch Intern Med. 2006 Oct 23;166(19):2145-50
references.pmid: 17060546
references.citation: Anadolu Kardiyol Derg. 2013 May;13(3):207-14
references.pmid: 23376648
references.citation: AIDS Patient Care STDS. 2009 Oct;23(10):809-13
references.pmid: 19824809
references.citation: World J Gastroenterol. 2014 Oct 28;20(40):14660-71
references.pmid: 25356029
references.citation: AIDS. 2014 Sep 10;28(14):2061-70
references.pmid: 25265074
references.citation: Am Heart J. 2001 Sep;142(3):402-10
references.pmid: 11526352
references.citation: AIDS Patient Care STDS. 2009 Oct;23(10):815-24
references.pmid: 19803679
references.citation: Nurs Stand. 2005 Nov 30-Dec 6;20(12):41-7
references.pmid: 16350501
references.citation: Am J Public Health. 2010 Oct;100(10):1896-903
references.pmid: 20724677
references.citation: Am J Forensic Med Pathol. 2008 Mar;29(1):9-13
references.pmid: 19749609
references.citation: Ann Intern Med. 2014 Apr 1;160(7):458-67
references.pmid: 24687069
references.citation: Behav Med. 2014;40(3):108-15
references.pmid: 25090363
references.citation: Am J Epidemiol. 1995 Aug 1;142(3):323-30
references.pmid: 7631636
references.citation: Circulation. 1975 Apr;51(4 Suppl):5-40
references.pmid: 1116248
references.citation: Am J Epidemiol. 2005 Mar 1;161(5):423-33
references.pmid: 15718478
references.citation: J Forensic Sci. 1999 Mar;44(2):359-68
references.pmid: 10097363
references.citation: BMC Infect Dis. 2013;13:274
references.pmid: 23773229
references.citation: Circulation. 2001 Jun 12;103(23):2805-9
references.pmid: 11401936
references.citation: Am J Cardiol. 2011 Jan;107(1):10-6
references.pmid: 21146679
references.citation: Eur J Clin Microbiol Infect Dis. 2004 Aug;23(8):625-30
references.pmid: 15322938
references.citation: N Engl J Med. 1998 Mar 26;338(13):853-60
references.pmid: 9516219
references.citation: Atherosclerosis. 2013 Aug;229(2):443-8
references.pmid: 23880201
references.citation: AIDS. 2010 Jan 16;24(2):243-53
references.pmid: 19996940
references.citation: Am J Epidemiol. 1987 Aug;126(2):310-8
references.pmid: 3300281
references.citation: ISRN AIDS. 2013 Dec 05;2013:737083
references.pmid: 24383040
references.citation: Recent Pat Cardiovasc Drug Discov. 2011 Jan;6(1):61-9
references.pmid: 21222651
references.citation: Arterioscler Thromb Vasc Biol. 2014 Feb;34(2):244-50
references.pmid: 24265418
references.citation: JACC Cardiovasc Imaging. 2013 Jun;6(6):651-7
references.pmid: 23490845
references.citation: J Behav Med. 2007 Oct;30(5):371-83
references.pmid: 17570050
references.citation: BMJ. 2006 May 27;332(7552):1244-8
references.pmid: 16672312
references.citation: J Cardiovasc Nurs. 2005 May-Jun;20(3):149-54
references.pmid: 15870584
references.citation: Atherosclerosis. 2004 Mar;173(1):79-87
references.pmid: 15177126
references.citation: Cardiol Rev. 2009 Sep-Oct;17(5):211-5
references.pmid: 19690471
references.citation: N Engl J Med. 1997 Dec 11;337(24):1705-14
references.pmid: 9392695
references.citation: MMWR Recomm Rep. 1992 Dec 18;41(RR-17):1-19
references.pmid: 1361652
references.citation: Nicotine Tob Res. 2005 Aug;7(4):511-22
references.pmid: 16085522
references.citation: Am Heart J. 2008 Mar;155(3):465-70
references.pmid: 18294478
references.citation: Curr Atheroscler Rep. 2010 Mar;12(2):119-24
references.pmid: 20425247
references.citation: Int J Cardiol. 2012 Nov 15;161(2):83-7
references.pmid: 21600668
references.citation: J Am Coll Cardiol. 2010 Mar 30;55(13):1328-35
references.pmid: 20338493
references.citation: AIDS Patient Care STDS. 2013 Jan;27(1):22-32
references.pmid: 23305259
references.citation: J Acquir Immune Defic Syndr. 2012 Oct 1;61(2):208-15
references.pmid: 22732470
references.citation: AIDS Res Treat. 2014;2014:237834
references.pmid: 25349726
references.citation: Cytometry B Clin Cytom. 2007 Jul;72(4):249-55
references.pmid: 17205569
references.citation: Addiction. 2009 Nov;104(11):1891-900
references.pmid: 19719796
references.citation: J Am Coll Cardiol. 2007 Jul 24;50(4):319-26
references.pmid: 17659199