Association between statin use, atherosclerosis, and mortality in HIV-infected adults
While HIV infection is associated with increased cardiovascular risk, benefit from statin is not well established in HIV-infected adults. We assessed whether statins are associated with a decrease in carotid artery intima-media thickness (cIMT) progression and all-cause mortality in HIV-infected adu...
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| description | While HIV infection is associated with increased cardiovascular risk, benefit from statin is not well established in HIV-infected adults. We assessed whether statins are associated with a decrease in carotid artery intima-media thickness (cIMT) progression and all-cause mortality in HIV-infected adults who are at elevated ASCVD risk and recommended for statins.
Carotid IMT was measured at baseline and follow-up in 127 HIV-infected adults who meet ACC/AHA criteria to be on statins. Inverse probability of treatment weighting (IPTW) was used to address selection bias. Multivariable models were used to control for baseline characteristics.
28 subjects (22%) were on statins and 99 subjects (78%) were not. Mean cIMT at baseline was 1.2 mm (SD = 0.34) in statin users and 1.1 mm (SD = 0.34) in non-users, and the multivariable adjusted difference was 0.05mm (95%CI -0.11, 0.21 p = 0.53). After 3.2 years of follow-up, average cIMT progression was similar in statin users and non-users (0.062mm/yr vs. 0.058 mm/yr) and the multivariable adjusted difference over the study period was 0.004 mm/yr (95% CI -0.018, 0.025, p = 0.74). All-cause mortality appeared higher in non-statin users compared with statin users, but the difference was not significant (adjusted HR = 0.74, 95%CI 0.17-3.29, p = 0.70).
In a HIV cohort who had elevated ASCVD risk and meet ACC/AHA criteria for statins, treatment with statins was not associated with a reduction in carotid atherosclerosis progression or total mortality. Future studies are needed to further explore the impact of statins on cardiovascular risk in the HIV-infected population. |
| doi_str_mv | 10.1371/journal.pone.0232636 |
| format | Article |
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Carotid IMT was measured at baseline and follow-up in 127 HIV-infected adults who meet ACC/AHA criteria to be on statins. Inverse probability of treatment weighting (IPTW) was used to address selection bias. Multivariable models were used to control for baseline characteristics.
28 subjects (22%) were on statins and 99 subjects (78%) were not. Mean cIMT at baseline was 1.2 mm (SD = 0.34) in statin users and 1.1 mm (SD = 0.34) in non-users, and the multivariable adjusted difference was 0.05mm (95%CI -0.11, 0.21 p = 0.53). After 3.2 years of follow-up, average cIMT progression was similar in statin users and non-users (0.062mm/yr vs. 0.058 mm/yr) and the multivariable adjusted difference over the study period was 0.004 mm/yr (95% CI -0.018, 0.025, p = 0.74). All-cause mortality appeared higher in non-statin users compared with statin users, but the difference was not significant (adjusted HR = 0.74, 95%CI 0.17-3.29, p = 0.70).
In a HIV cohort who had elevated ASCVD risk and meet ACC/AHA criteria for statins, treatment with statins was not associated with a reduction in carotid atherosclerosis progression or total mortality. Future studies are needed to further explore the impact of statins on cardiovascular risk in the HIV-infected population.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0232636</identifier><identifier>PMID: 32353062</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adults ; Arteriosclerosis ; Atherosclerosis ; Biology and Life Sciences ; Cardiovascular disease ; Cardiovascular diseases ; Carotid artery ; Carotid Artery Diseases - diagnosis ; Carotid Artery Diseases - epidemiology ; Carotid Artery Diseases - prevention & control ; Carotid Intima-Media Thickness ; Cause of Death ; Cohort Studies ; Disease Progression ; Female ; Follow-Up Studies ; Health risk assessment ; Health risks ; HIV ; HIV Infections - complications ; HIV Infections - mortality ; Human immunodeficiency virus ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Male ; Measurement methods ; Medicine and Health Sciences ; Middle Aged ; Mortality ; Multivariable control ; Risk ; Risk Assessment ; Risk Factors ; Statins</subject><ispartof>PloS one, 2020-04, Vol.15 (4), p.e0232636</ispartof><rights>2020 Phan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Phan et al 2020 Phan et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-727053a422671568594f8e2215538bd0b27511581dd70466337f8106c16259993</citedby><cites>FETCH-LOGICAL-c526t-727053a422671568594f8e2215538bd0b27511581dd70466337f8106c16259993</cites><orcidid>0000-0003-1573-7286</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192415/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7192415/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32353062$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Wright, James M.</contributor><creatorcontrib>Phan, Binh An P</creatorcontrib><creatorcontrib>Ma, Yifei</creatorcontrib><creatorcontrib>Scherzer, Rebecca</creatorcontrib><creatorcontrib>Deeks, Steven G</creatorcontrib><creatorcontrib>Hsue, Priscilla Y</creatorcontrib><title>Association between statin use, atherosclerosis, and mortality in HIV-infected adults</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>While HIV infection is associated with increased cardiovascular risk, benefit from statin is not well established in HIV-infected adults. We assessed whether statins are associated with a decrease in carotid artery intima-media thickness (cIMT) progression and all-cause mortality in HIV-infected adults who are at elevated ASCVD risk and recommended for statins.
Carotid IMT was measured at baseline and follow-up in 127 HIV-infected adults who meet ACC/AHA criteria to be on statins. Inverse probability of treatment weighting (IPTW) was used to address selection bias. Multivariable models were used to control for baseline characteristics.
28 subjects (22%) were on statins and 99 subjects (78%) were not. Mean cIMT at baseline was 1.2 mm (SD = 0.34) in statin users and 1.1 mm (SD = 0.34) in non-users, and the multivariable adjusted difference was 0.05mm (95%CI -0.11, 0.21 p = 0.53). After 3.2 years of follow-up, average cIMT progression was similar in statin users and non-users (0.062mm/yr vs. 0.058 mm/yr) and the multivariable adjusted difference over the study period was 0.004 mm/yr (95% CI -0.018, 0.025, p = 0.74). All-cause mortality appeared higher in non-statin users compared with statin users, but the difference was not significant (adjusted HR = 0.74, 95%CI 0.17-3.29, p = 0.70).
In a HIV cohort who had elevated ASCVD risk and meet ACC/AHA criteria for statins, treatment with statins was not associated with a reduction in carotid atherosclerosis progression or total mortality. Future studies are needed to further explore the impact of statins on cardiovascular risk in the HIV-infected population.</description><subject>Adults</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Biology and Life Sciences</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular diseases</subject><subject>Carotid artery</subject><subject>Carotid Artery Diseases - diagnosis</subject><subject>Carotid Artery Diseases - epidemiology</subject><subject>Carotid Artery Diseases - prevention & control</subject><subject>Carotid Intima-Media Thickness</subject><subject>Cause of Death</subject><subject>Cohort Studies</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV Infections - complications</subject><subject>HIV Infections - mortality</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - 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diagnosis</topic><topic>Carotid Artery Diseases - epidemiology</topic><topic>Carotid Artery Diseases - prevention & control</topic><topic>Carotid Intima-Media Thickness</topic><topic>Cause of Death</topic><topic>Cohort Studies</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>HIV</topic><topic>HIV Infections - complications</topic><topic>HIV Infections - mortality</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use</topic><topic>Male</topic><topic>Measurement methods</topic><topic>Medicine and Health Sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariable control</topic><topic>Risk</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Statins</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Phan, Binh An P</creatorcontrib><creatorcontrib>Ma, Yifei</creatorcontrib><creatorcontrib>Scherzer, Rebecca</creatorcontrib><creatorcontrib>Deeks, Steven G</creatorcontrib><creatorcontrib>Hsue, Priscilla Y</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Phan, Binh An P</au><au>Ma, Yifei</au><au>Scherzer, Rebecca</au><au>Deeks, Steven G</au><au>Hsue, Priscilla Y</au><au>Wright, James M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between statin use, atherosclerosis, and mortality in HIV-infected adults</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2020-04-30</date><risdate>2020</risdate><volume>15</volume><issue>4</issue><spage>e0232636</spage><pages>e0232636-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>While HIV infection is associated with increased cardiovascular risk, benefit from statin is not well established in HIV-infected adults. We assessed whether statins are associated with a decrease in carotid artery intima-media thickness (cIMT) progression and all-cause mortality in HIV-infected adults who are at elevated ASCVD risk and recommended for statins.
Carotid IMT was measured at baseline and follow-up in 127 HIV-infected adults who meet ACC/AHA criteria to be on statins. Inverse probability of treatment weighting (IPTW) was used to address selection bias. Multivariable models were used to control for baseline characteristics.
28 subjects (22%) were on statins and 99 subjects (78%) were not. Mean cIMT at baseline was 1.2 mm (SD = 0.34) in statin users and 1.1 mm (SD = 0.34) in non-users, and the multivariable adjusted difference was 0.05mm (95%CI -0.11, 0.21 p = 0.53). After 3.2 years of follow-up, average cIMT progression was similar in statin users and non-users (0.062mm/yr vs. 0.058 mm/yr) and the multivariable adjusted difference over the study period was 0.004 mm/yr (95% CI -0.018, 0.025, p = 0.74). All-cause mortality appeared higher in non-statin users compared with statin users, but the difference was not significant (adjusted HR = 0.74, 95%CI 0.17-3.29, p = 0.70).
In a HIV cohort who had elevated ASCVD risk and meet ACC/AHA criteria for statins, treatment with statins was not associated with a reduction in carotid atherosclerosis progression or total mortality. Future studies are needed to further explore the impact of statins on cardiovascular risk in the HIV-infected population.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32353062</pmid><doi>10.1371/journal.pone.0232636</doi><orcidid>https://orcid.org/0000-0003-1573-7286</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adults Arteriosclerosis Atherosclerosis Biology and Life Sciences Cardiovascular disease Cardiovascular diseases Carotid artery Carotid Artery Diseases - diagnosis Carotid Artery Diseases - epidemiology Carotid Artery Diseases - prevention & control Carotid Intima-Media Thickness Cause of Death Cohort Studies Disease Progression Female Follow-Up Studies Health risk assessment Health risks HIV HIV Infections - complications HIV Infections - mortality Human immunodeficiency virus Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Male Measurement methods Medicine and Health Sciences Middle Aged Mortality Multivariable control Risk Risk Assessment Risk Factors Statins |
| title | Association between statin use, atherosclerosis, and mortality in HIV-infected adults |
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