Presence, Characteristics, and Prognostic Associations of Carotid Plaque Among People Living With HIV
Data from broad populations have established associations between incidental carotid plaque and vascular events. Among people living with HIV (PLWHIV), the risk of vascular events is increased; however, whether incidental carotid plaque is increased and there is an association between incidental car...
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| Veröffentlicht in: | Circulation. Cardiovascular imaging 2017-10, Vol.10 (10) |
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| creator | Janjua, Sumbal A Staziaki, Pedro V Szilveszter, Balint Takx, Richard A P Mayrhofer, Thomas Hennessy, Orla Emami, Hamed A Park, Jakob Ivanov, Alexander Hallett, Travis R Lu, Michael T Romero, Javier M Grinspoon, Steven K Hoffmann, Udo Zanni, Markella V Neilan, Tomas G |
| description | Data from broad populations have established associations between incidental carotid plaque and vascular events. Among people living with HIV (PLWHIV), the risk of vascular events is increased; however, whether incidental carotid plaque is increased and there is an association between incidental carotid plaque, plaque characteristics, and vascular events among PLWHIV is unclear.
Data from the multi-institutional Research Patient Data Registry were used. Presence and characteristics (high-risk plaque, including spotty calcification and low attenuation) of carotid plaque by computerized tomography among PLWHIV without known vascular disease were described. Data were compared with uninfected controls similar in age, sex, and cardiovascular risk factors, including diabetes mellitus, hyperlipidemia, and cigarette smoking to cases. Primary outcome was an atherosclerotic cardiovascular disease event, and secondary outcome was ischemic stroke. Cohort consisted of 209 PLWHIV (45±10 years, 72% male) and 168 controls. Using computerized tomography, PLWHIV without vascular disease had higher rates of any carotid plaque (34% versus 25%;
=0.04), noncalcified (18% versus 5%; |
| doi_str_mv | 10.1161/CIRCIMAGING.116.005777 |
| format | Article |
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Data from the multi-institutional Research Patient Data Registry were used. Presence and characteristics (high-risk plaque, including spotty calcification and low attenuation) of carotid plaque by computerized tomography among PLWHIV without known vascular disease were described. Data were compared with uninfected controls similar in age, sex, and cardiovascular risk factors, including diabetes mellitus, hyperlipidemia, and cigarette smoking to cases. Primary outcome was an atherosclerotic cardiovascular disease event, and secondary outcome was ischemic stroke. Cohort consisted of 209 PLWHIV (45±10 years, 72% male) and 168 controls. Using computerized tomography, PLWHIV without vascular disease had higher rates of any carotid plaque (34% versus 25%;
=0.04), noncalcified (18% versus 5%;
<0.001) and high-risk plaque (25% versus 16%;
=0.03). Over a follow-up of 3 years, 19 atherosclerotic cardiovascular disease events (9 strokes) occurred. Carotid plaque was independently associated with a 3-fold increase in atherosclerotic cardiovascular disease events among PLWHIV (hazard ratio, 2.91; confidence interval, 1.10-7.7,
=0.03) and a 4-fold increased risk of stroke (hazard ratio, 4.43; confidence interval, 1.17-16.70;
=0.02); high-risk plaque was associated with a 3-fold increased risk of atherosclerotic cardiovascular disease events and a 4-fold increased risk of stroke.
There is an increase in incidental carotid plaque, noncalcified plaque, and high-risk plaque among PLWHIV, and the presence and characteristics of carotid plaque are associated with subsequent vascular events.</description><identifier>ISSN: 1941-9651</identifier><identifier>EISSN: 1942-0080</identifier><identifier>DOI: 10.1161/CIRCIMAGING.116.005777</identifier><identifier>PMID: 29021257</identifier><language>eng</language><publisher>United States</publisher><subject>Adult ; Brain Ischemia - epidemiology ; Carotid Arteries - diagnostic imaging ; Carotid Arteries - pathology ; Carotid Artery Diseases - diagnostic imaging ; Carotid Artery Diseases - epidemiology ; Carotid Artery Diseases - pathology ; Chi-Square Distribution ; Comorbidity ; Computed Tomography Angiography ; Disease Progression ; Disease-Free Survival ; Female ; HIV Infections - diagnosis ; HIV Infections - epidemiology ; Humans ; Incidence ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Plaque, Atherosclerotic ; Proportional Hazards Models ; Registries ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Rupture, Spontaneous ; Stroke - epidemiology ; Time Factors ; United States - epidemiology</subject><ispartof>Circulation. Cardiovascular imaging, 2017-10, Vol.10 (10)</ispartof><rights>2017 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c359t-113adf57007455401b904c9c66e42b4cf4f37b8b25758f76d9c3f8db5e186b2b3</citedby><cites>FETCH-LOGICAL-c359t-113adf57007455401b904c9c66e42b4cf4f37b8b25758f76d9c3f8db5e186b2b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3687,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29021257$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Janjua, Sumbal A</creatorcontrib><creatorcontrib>Staziaki, Pedro V</creatorcontrib><creatorcontrib>Szilveszter, Balint</creatorcontrib><creatorcontrib>Takx, Richard A P</creatorcontrib><creatorcontrib>Mayrhofer, Thomas</creatorcontrib><creatorcontrib>Hennessy, Orla</creatorcontrib><creatorcontrib>Emami, Hamed A</creatorcontrib><creatorcontrib>Park, Jakob</creatorcontrib><creatorcontrib>Ivanov, Alexander</creatorcontrib><creatorcontrib>Hallett, Travis R</creatorcontrib><creatorcontrib>Lu, Michael T</creatorcontrib><creatorcontrib>Romero, Javier M</creatorcontrib><creatorcontrib>Grinspoon, Steven K</creatorcontrib><creatorcontrib>Hoffmann, Udo</creatorcontrib><creatorcontrib>Zanni, Markella V</creatorcontrib><creatorcontrib>Neilan, Tomas G</creatorcontrib><title>Presence, Characteristics, and Prognostic Associations of Carotid Plaque Among People Living With HIV</title><title>Circulation. Cardiovascular imaging</title><addtitle>Circ Cardiovasc Imaging</addtitle><description>Data from broad populations have established associations between incidental carotid plaque and vascular events. Among people living with HIV (PLWHIV), the risk of vascular events is increased; however, whether incidental carotid plaque is increased and there is an association between incidental carotid plaque, plaque characteristics, and vascular events among PLWHIV is unclear.
Data from the multi-institutional Research Patient Data Registry were used. Presence and characteristics (high-risk plaque, including spotty calcification and low attenuation) of carotid plaque by computerized tomography among PLWHIV without known vascular disease were described. Data were compared with uninfected controls similar in age, sex, and cardiovascular risk factors, including diabetes mellitus, hyperlipidemia, and cigarette smoking to cases. Primary outcome was an atherosclerotic cardiovascular disease event, and secondary outcome was ischemic stroke. Cohort consisted of 209 PLWHIV (45±10 years, 72% male) and 168 controls. Using computerized tomography, PLWHIV without vascular disease had higher rates of any carotid plaque (34% versus 25%;
=0.04), noncalcified (18% versus 5%;
<0.001) and high-risk plaque (25% versus 16%;
=0.03). Over a follow-up of 3 years, 19 atherosclerotic cardiovascular disease events (9 strokes) occurred. Carotid plaque was independently associated with a 3-fold increase in atherosclerotic cardiovascular disease events among PLWHIV (hazard ratio, 2.91; confidence interval, 1.10-7.7,
=0.03) and a 4-fold increased risk of stroke (hazard ratio, 4.43; confidence interval, 1.17-16.70;
=0.02); high-risk plaque was associated with a 3-fold increased risk of atherosclerotic cardiovascular disease events and a 4-fold increased risk of stroke.
There is an increase in incidental carotid plaque, noncalcified plaque, and high-risk plaque among PLWHIV, and the presence and characteristics of carotid plaque are associated with subsequent vascular events.</description><subject>Adult</subject><subject>Brain Ischemia - epidemiology</subject><subject>Carotid Arteries - diagnostic imaging</subject><subject>Carotid Arteries - pathology</subject><subject>Carotid Artery Diseases - diagnostic imaging</subject><subject>Carotid Artery Diseases - epidemiology</subject><subject>Carotid Artery Diseases - pathology</subject><subject>Chi-Square Distribution</subject><subject>Comorbidity</subject><subject>Computed Tomography Angiography</subject><subject>Disease Progression</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>HIV Infections - diagnosis</subject><subject>HIV Infections - epidemiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Plaque, Atherosclerotic</subject><subject>Proportional Hazards Models</subject><subject>Registries</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Rupture, Spontaneous</subject><subject>Stroke - epidemiology</subject><subject>Time Factors</subject><subject>United States - epidemiology</subject><issn>1941-9651</issn><issn>1942-0080</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkM1OwzAQhC0EoqXwCpWPHJpiJ3acHKMI2kgFKsTPMbIduzVK4mKnSLw9CS2I0-6OZndHHwBTjOYYx_gmL57y4j5bFA-LQZgjRBljJ2CMUxIGCCXo9KfHQRpTPAIX3r8jFEeIJudgFKYoxCFlY6DWTnnVSjWD-ZY7LjvljO-M9DPI2wqund20dhBg5r2VhnfGth5aDXPubGd6S80_9gpmjW03cK3srlZwZT5NP72ZbguXxeslONO89urqWCfg5e72OV8Gq8dFkWerQEY07QKMI15pyhBihFKCsEgRkamMY0VCQaQmOmIiEX1ymmgWV6mMdFIJqnASi1BEE3B9uLtzts_ku7IxXqq65q2ye1_ilCKCewphb40PVums907pcudMw91XiVE5IC7_IR6E8oC4X5wef-xFo6q_tV-m0TcKWnfg</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Janjua, Sumbal A</creator><creator>Staziaki, Pedro V</creator><creator>Szilveszter, Balint</creator><creator>Takx, Richard A P</creator><creator>Mayrhofer, Thomas</creator><creator>Hennessy, Orla</creator><creator>Emami, Hamed A</creator><creator>Park, Jakob</creator><creator>Ivanov, Alexander</creator><creator>Hallett, Travis R</creator><creator>Lu, Michael T</creator><creator>Romero, Javier M</creator><creator>Grinspoon, Steven K</creator><creator>Hoffmann, Udo</creator><creator>Zanni, Markella V</creator><creator>Neilan, Tomas G</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201710</creationdate><title>Presence, Characteristics, and Prognostic Associations of Carotid Plaque Among People Living With HIV</title><author>Janjua, Sumbal A ; Staziaki, Pedro V ; Szilveszter, Balint ; Takx, Richard A P ; Mayrhofer, Thomas ; Hennessy, Orla ; Emami, Hamed A ; Park, Jakob ; Ivanov, Alexander ; Hallett, Travis R ; Lu, Michael T ; Romero, Javier M ; Grinspoon, Steven K ; Hoffmann, Udo ; Zanni, Markella V ; Neilan, Tomas G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c359t-113adf57007455401b904c9c66e42b4cf4f37b8b25758f76d9c3f8db5e186b2b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Brain Ischemia - epidemiology</topic><topic>Carotid Arteries - diagnostic imaging</topic><topic>Carotid Arteries - pathology</topic><topic>Carotid Artery Diseases - diagnostic imaging</topic><topic>Carotid Artery Diseases - epidemiology</topic><topic>Carotid Artery Diseases - pathology</topic><topic>Chi-Square Distribution</topic><topic>Comorbidity</topic><topic>Computed Tomography Angiography</topic><topic>Disease Progression</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>HIV Infections - diagnosis</topic><topic>HIV Infections - epidemiology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Plaque, Atherosclerotic</topic><topic>Proportional Hazards Models</topic><topic>Registries</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Rupture, Spontaneous</topic><topic>Stroke - epidemiology</topic><topic>Time Factors</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Janjua, Sumbal A</creatorcontrib><creatorcontrib>Staziaki, Pedro V</creatorcontrib><creatorcontrib>Szilveszter, Balint</creatorcontrib><creatorcontrib>Takx, Richard A P</creatorcontrib><creatorcontrib>Mayrhofer, Thomas</creatorcontrib><creatorcontrib>Hennessy, Orla</creatorcontrib><creatorcontrib>Emami, Hamed A</creatorcontrib><creatorcontrib>Park, Jakob</creatorcontrib><creatorcontrib>Ivanov, Alexander</creatorcontrib><creatorcontrib>Hallett, Travis R</creatorcontrib><creatorcontrib>Lu, Michael T</creatorcontrib><creatorcontrib>Romero, Javier M</creatorcontrib><creatorcontrib>Grinspoon, Steven K</creatorcontrib><creatorcontrib>Hoffmann, Udo</creatorcontrib><creatorcontrib>Zanni, Markella V</creatorcontrib><creatorcontrib>Neilan, Tomas G</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Cardiovascular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Janjua, Sumbal A</au><au>Staziaki, Pedro V</au><au>Szilveszter, Balint</au><au>Takx, Richard A P</au><au>Mayrhofer, Thomas</au><au>Hennessy, Orla</au><au>Emami, Hamed A</au><au>Park, Jakob</au><au>Ivanov, Alexander</au><au>Hallett, Travis R</au><au>Lu, Michael T</au><au>Romero, Javier M</au><au>Grinspoon, Steven K</au><au>Hoffmann, Udo</au><au>Zanni, Markella V</au><au>Neilan, Tomas G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Presence, Characteristics, and Prognostic Associations of Carotid Plaque Among People Living With HIV</atitle><jtitle>Circulation. Cardiovascular imaging</jtitle><addtitle>Circ Cardiovasc Imaging</addtitle><date>2017-10</date><risdate>2017</risdate><volume>10</volume><issue>10</issue><issn>1941-9651</issn><eissn>1942-0080</eissn><abstract>Data from broad populations have established associations between incidental carotid plaque and vascular events. Among people living with HIV (PLWHIV), the risk of vascular events is increased; however, whether incidental carotid plaque is increased and there is an association between incidental carotid plaque, plaque characteristics, and vascular events among PLWHIV is unclear.
Data from the multi-institutional Research Patient Data Registry were used. Presence and characteristics (high-risk plaque, including spotty calcification and low attenuation) of carotid plaque by computerized tomography among PLWHIV without known vascular disease were described. Data were compared with uninfected controls similar in age, sex, and cardiovascular risk factors, including diabetes mellitus, hyperlipidemia, and cigarette smoking to cases. Primary outcome was an atherosclerotic cardiovascular disease event, and secondary outcome was ischemic stroke. Cohort consisted of 209 PLWHIV (45±10 years, 72% male) and 168 controls. Using computerized tomography, PLWHIV without vascular disease had higher rates of any carotid plaque (34% versus 25%;
=0.04), noncalcified (18% versus 5%;
<0.001) and high-risk plaque (25% versus 16%;
=0.03). Over a follow-up of 3 years, 19 atherosclerotic cardiovascular disease events (9 strokes) occurred. Carotid plaque was independently associated with a 3-fold increase in atherosclerotic cardiovascular disease events among PLWHIV (hazard ratio, 2.91; confidence interval, 1.10-7.7,
=0.03) and a 4-fold increased risk of stroke (hazard ratio, 4.43; confidence interval, 1.17-16.70;
=0.02); high-risk plaque was associated with a 3-fold increased risk of atherosclerotic cardiovascular disease events and a 4-fold increased risk of stroke.
There is an increase in incidental carotid plaque, noncalcified plaque, and high-risk plaque among PLWHIV, and the presence and characteristics of carotid plaque are associated with subsequent vascular events.</abstract><cop>United States</cop><pmid>29021257</pmid><doi>10.1161/CIRCIMAGING.116.005777</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Brain Ischemia - epidemiology Carotid Arteries - diagnostic imaging Carotid Arteries - pathology Carotid Artery Diseases - diagnostic imaging Carotid Artery Diseases - epidemiology Carotid Artery Diseases - pathology Chi-Square Distribution Comorbidity Computed Tomography Angiography Disease Progression Disease-Free Survival Female HIV Infections - diagnosis HIV Infections - epidemiology Humans Incidence Kaplan-Meier Estimate Male Middle Aged Multivariate Analysis Plaque, Atherosclerotic Proportional Hazards Models Registries Retrospective Studies Risk Assessment Risk Factors Rupture, Spontaneous Stroke - epidemiology Time Factors United States - epidemiology |
| title | Presence, Characteristics, and Prognostic Associations of Carotid Plaque Among People Living With HIV |
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