title: Association of increased CD8+ and persisting C-reactive protein levels with restenosis in HIV patients after coronary stenting.
abstract: The life expectancy of HIV-infected patients has recently been increasing. Although the mortality and morbidity associated with AIDS is decreasing, those associated with cardiovascular diseases and percutaneous coronary intervention (PCI) are receiving greater attention. Only limited data regarding coronary restenosis are available in these patients.
  
  
  
  In this prospective, systematic angiographic follow-up study, we enrolled HIV patients who underwent PCI for de-novo lesions and subsequent routine angiographic follow-up for 6-8 months. Angiographic restenosis was defined as stenosis of at least 50% of the in-segment area.
  
  
  
  Univariate and multivariate analyses were performed to evaluate restenosis and its predictors.
  
  
  
  Between May 2002 and March 2014, 47 patients with HIV underwent PCI in two high-volume centers in Munich, Germany. Of these patients, 41 with 131 de-novo lesions underwent invasive surveillance. One-quarter of the lesions treated subsequently presented with restenosis. Univariate analysis indicated that CD8 T-cell levels (P = 0.006), serum cholesterol (P = 0.042) and low-density lipoprotein-cholesterol (P = 0.042) levels at baseline, total number of stents (P = 0.047), and C-reactive protein level (P = 0.001) at follow-up were associated with restenosis. Multivariate analysis indicated that CD8 T-cell levels (P = 0.006) and persistent C-reactive protein elevation at 6-month follow-up (P = 0.00013) were independent predictors of restenosis.
  
  
  
  Inflammation, represented by CD8 T-cell levels, and persistent C-reactive protein elevation are independent predictors of angiographic restenosis and should therefore be closely monitored in HIV patients undergoing PCI.
authors.affiliation: aI. Medizinische Klinik und Poliklinik bII. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München cDeutsches Herzzentrum München dInstitut für Medizinische Statistik und Epidemiologie, Technische Universität München eMedizinisches Versorgungszentrum am Stachus, München fGerman Centre for Cardiovascular Research (DZHK), partner site Munich Heart Alliance, Berlin, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Schneider
authors.forename: Christoph D
authors.initials: CD
authors.lastname: Spinner
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cassese
authors.forename: Dominik
authors.initials: D
authors.lastname: Promny
authors.forename: Alexander
authors.initials: A
authors.lastname: Hapfelmeier
authors.forename: Robert A
authors.initials: RA
authors.lastname: Byrne
authors.forename: Marcus
authors.initials: M
authors.lastname: Baumann
authors.forename: Hans
authors.initials: H
authors.lastname: Jäger
authors.forename: Eva
authors.initials: E
authors.lastname: Steinlechner
authors.forename: Karl-Ludwig
authors.initials: KL
authors.lastname: Laugwitz
authors.forename: Adnan
authors.initials: A
authors.lastname: Kastrati
mesh_terms: D000368:Aged; D000792:Angiography; D002097:C-Reactive Protein / Q000032:analysis*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment
chemical_list: D002097:C-Reactive Protein