title: High-risk coronary plaque, invasive coronary procedures, and cardiac events among HIV-positive individuals and matched controls.
abstract: BACKGROUND
  Human immunodeficiency virus (HIV) infection is considered a chronic, treatable disease, although treatment is associated with increased rates of coronary artery disease (CAD). We analyzed the utility of coronary CTA in the assessment of CAD among HIV patients and explored whether HIV patients are at greater risk of associated morbidity and mortality compared to HIV-negative controls.
  
  
  METHODS
  In a retrospective, single center cohort study 97 males without history of previous coronary artery disease who had undergone coronary CTA between 2011 and 2014 was analyzed, including 32 HIV positive patients and 65 matched HIV negative controls. Presence and composition of coronary plaque was determined by coronary CTA. Data on subsequent coronary events and coronary intervention was collected.
  
  
  RESULTS
  Patients with HIV had higher rates of non-calcified plaque (0.8 ± 1.5 versus 0.3 ± 0.7, p = 0.03) compared to negative controls. At a median follow-up of 38 months, patients with HIV were at greater risk of non-ST elevation acute coronary syndrome (16% versus 3%, p < 0.04), although there was no difference in the combined endpoint of all acute coronary syndromes (19% versus 6%, p = 0.08). Following baseline coronary TCA, there was a higher rate of coronary intervention in patients without HIV (mean time to event 9.9 ± 3.3 versus 20.6 ± 4.9 months, p < 0.04).
  
  
  CONCLUSIONS
  Patients with HIV more pronounces coronary atherosclerosis on coronary CTA and higher rates of non-ST elevation acute coronary syndromes compared to negative controls.
authors: University of Notre Dame, Sydney, Australia; St. Vincent's Hospital, Sydney, Australia. Electronic address: james.r.nadel@gmail.com.
authors: James
authors: J
authors: Nadel
authors: St. Vincent's Hospital, Sydney, Australia.
authors: Eoin
authors: E
authors: O'Dwyer
authors: University of Notre Dame, Sydney, Australia; St. Vincent's Hospital, Sydney, Australia.
authors: Sam
authors: S
authors: Emmanuel
authors: St. Vincent's Hospital, Sydney, Australia.
authors: Justyn
authors: J
authors: Huang
authors: St. Vincent's Hospital, Sydney, Australia.
authors: Sarat
authors: S
authors: Cheruvu
authors: University of Notre Dame, Sydney, Australia; St. Vincent's Hospital, Sydney, Australia.
authors: Neville
authors: N
authors: Sammel
authors: St. Vincent's Hospital, Sydney, Australia; Peter Duncan Neurosciences Unit St Vincent's Centre for Applied Medical Research University of New South Wales, Sydney, Australia.
authors: Bruce
authors: B
authors: Brew
authors: St. Vincent's Hospital, Sydney, Australia; Victor Chang Cardiac Research Institute, Sydney, Australia.
authors: James
authors: J
authors: Otton
authors: University of Notre Dame, Sydney, Australia; St. Vincent's Hospital, Sydney, Australia; Victor Chang Cardiac Research Institute, Sydney, Australia.
authors: Cameron J
authors: CJ
authors: Holloway
mesh_terms: D054058:Acute Coronary Syndrome / Q000209:etiology; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D018450:Disease Progression; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D020276:HIV Long-Term Survivors; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D000072658:Non-ST Elevated Myocardial Infarction / Q000209:etiology; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012422:Rupture, Spontaneous; D012720:Severity of Illness Index; D013997:Time Factors
keywords: Acute coronary syndrome; CT coronary angiography; Coronary artery disease; HIV