title: Inflammatory Markers Associated With Subclinical Coronary Artery Disease: The Multicenter AIDS Cohort Study.
abstract: Despite evidence for higher risk of coronary artery disease among HIV+ individuals, the underlying mechanisms are not well understood. We investigated associations of inflammatory markers with subclinical coronary artery disease in 923 participants of the Multicenter AIDS Cohort Study (575 HIV+ and 348 HIV- men) who underwent noncontrast computed tomography scans for coronary artery calcification, the majority (n=692) also undergoing coronary computed tomography angiography.
  
  
  
  Outcomes included presence and extent of coronary artery calcification, plus computed tomography angiography analysis of presence, composition, and extent of coronary plaques and severity of coronary stenosis. HIV+ men had significantly higher levels of interleukin-6 (IL-6), intercellular adhesion molecule-1, C-reactive protein, and soluble-tumor necrosis factor-α receptor (sTNFαR) I and II (all P<0.01) and a higher prevalence of noncalcified plaque (63% versus 54%, P=0.02) on computed tomography angiography. Among HIV+ men, for every SD increase in log-interleukin-6 and log intercellular adhesion molecule-1, there was a 30% and 60% increase, respectively, in the prevalence of coronary stenosis ≥50% (all P<0.05). Similarly, sTNFαR I and II in HIV+ participants were associated with an increase in prevalence of coronary stenosis ≥70% (P<0.05). Higher levels of interleukin-6, sTNFαR I, and sTNFαR II were also associated with greater coronary artery calcification score in HIV+ men (P<0.01).
  
  
  
  Higher inflammatory marker levels are associated with greater prevalence of coronary stenosis in HIV+ men. Our findings underscore the need for further study to elucidate the relationships of inflammatory pathways with coronary artery disease in HIV+ individuals.
authors.affiliation: Division of Cardiovascular Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA Cardiovascular Institute and Division of Cardiovascular Medicine, Stanford University, Stanford, CA hbahrami@usc.edu.
authors.forename: Hossein
authors.initials: H
authors.lastname: Bahrami
authors.affiliation: Division of Cardiology, Harbor-UCLA Medical Center, Torrance, CA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Budoff
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Sabina A
authors.initials: SA
authors.lastname: Haberlen
authors.affiliation: Division of Cardiology, Harbor-UCLA Medical Center, Torrance, CA.
authors.forename: Pantea
authors.initials: P
authors.lastname: Rezaeian
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Kerunne
authors.initials: K
authors.lastname: Ketlogetswe
authors.affiliation: Departments of Pathology & Laboratory Medicine, and Biochemistry, University of Vermont College of Medicine, Colchester, VT.
authors.forename: Russell
authors.initials: R
authors.lastname: Tracy
authors.affiliation: Northwestern University, Evanston, IL.
authors.forename: Frank
authors.initials: F
authors.lastname: Palella
authors.affiliation: University of Pittsburgh, PA.
authors.forename: Mallory D
authors.initials: MD
authors.lastname: Witt
authors.affiliation: Cardiovascular Institute and Division of Cardiovascular Medicine, Stanford University, Stanford, CA.
authors.forename: Michael V
authors.initials: MV
authors.lastname: McConnell
authors.affiliation: University of Pittsburgh, PA.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Kingsley
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism; D000072226:Computed Tomography Angiography / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000821:virology; D023921:Coronary Stenosis / Q000097:blood / Q000175:diagnosis / Q000821:virology*; D015658:HIV Infections / Q000097:blood*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D018124:Receptors, Tumor Necrosis Factor / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D061205:Vascular Calcification / Q000097:blood / Q000175:diagnosis / Q000821:virology*
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D015850:Interleukin-6; D018124:Receptors, Tumor Necrosis Factor; D014409:Tumor Necrosis Factor-alpha; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein
keywords: HIV; HIV infection; atherosclerosis; cardiac biomarkers; cardiac computed tomography; coronary artery calcium; coronary artery disease; coronary computed tomography scan; epidemiology; inflammation