TY - JOUR
T1 - Mild renal impairment is associated with calcified plaque parameters assessed by computed tomography angiography in people living with HIV
AU - Cheru, Lediya T.
AU - Fitch, Kathleen V.
AU - Saylor, Charles F.
AU - Lu, Michael
AU - Hoffmann, Udo
AU - Lo, Janet
AU - Grinspoon, Steven K.
N1 - Funding Information:
Declaration of interest: L.T.C., K.V.F., C.F.S. have nothing to declare. U.H. received grant support from Siemens Healthcare, the American College of Radiology Imaging Network, and HeartFlow Inc. M.L. received consulting fees from PQBypass and research support from NVIDIA. J.L. participated in a Scientific Advisory Board meeting for Gilead Sciences and served as a consultant for Viiv Healthcare; S.K.G. has received research funding from Gilead Sciences, KOWA, and Theratechnologies, and served as a consultant for Navidea Inc. and Theratechnologies. All declaration of interests of coauthors are unrelated to the design of this study and the preparation of this manuscript.
Funding Information:
Funding sources: This work was supported by NIH RO1HL123351 (J.L.), NIH K23HL092792 (J.L.), NIH 5T32DK007028-44 (L.T.C.), and Bristol Myers Squibb, Inc. This project was also supported by Grant Number 1 UL1 RR025758-04, the Harvard Clinical and Translational Science Center, the National Center for Research Resources, and the Nutrition Obesity Research Center at Harvard, P30DK 040561. Funding sources were not involved in the design of the study, data analysis or the writing of the manuscript.
Publisher Copyright:
© 2018 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - To investigate the association of mild renal impairment and coronary plaque in people living with HIV (PLHIV).Methods:PLHIV and non-HIV controls with serum creatinine less than 1.5mg/dl were investigated. Estimated glomerular filtration rate (eGFR) (calculated by CKD-EPI formula) was related to coronary plaque indices obtained by CT angiography.Results:One hundred and eighty-four PLHIV [HIV viral load, 49 (47,49) copies/ml, CD4 cell count, median 536 (370, 770) cells/μl, duration HIV, 15±7 years] and 72 HIV-negative controls without known cardiovascular disease (CVD) were studied. The two groups were well matched for traditional CVD risk factors. Serum creatinine (0.9±0.2 vs. 0.9±0.2mg/dl, P=0.96) and eGFR (96±22 vs. 96±24ml/min per 1.73m2, P=0.99) were similar between PLHIV and non-HIV, respectively. In PLHIV, eGFR inversely related to total severity of coronary plaque score (r=-0.27, P=0.002), total coronary segments with plaque (r=-0.21, P=0.005), calcified plaque segments (r=-0.15, P=0.045), and Agatston score (r=-0.21, P=0.006). Adjusting for total Framingham point score, BMI, and HIV parameters, eGFR remained significantly associated with calcified plaque and Agatston score in PLHIV. In HIV negative controls, eGFR did not correlate with calcified plaque (r=-0.20, P=0.10) or Agatston score (r=-0.13, P=0.29). Among PLHIV, those with eGFR less than 90ml/min per 1.73m2 demonstrated increased total severity of coronary plaque score compared with those with eGFR greater than or equal to 90, P=0.02). This relationship was stronger in PLHIV than the non-HIV group.Conclusion:Our data highlight a robust relationship between subclinical renal impairment and coronary artery disease among PLHIV. Further research is needed to understand the relationship between mild renal impairment and CVD in HIV.
AB - To investigate the association of mild renal impairment and coronary plaque in people living with HIV (PLHIV).Methods:PLHIV and non-HIV controls with serum creatinine less than 1.5mg/dl were investigated. Estimated glomerular filtration rate (eGFR) (calculated by CKD-EPI formula) was related to coronary plaque indices obtained by CT angiography.Results:One hundred and eighty-four PLHIV [HIV viral load, 49 (47,49) copies/ml, CD4 cell count, median 536 (370, 770) cells/μl, duration HIV, 15±7 years] and 72 HIV-negative controls without known cardiovascular disease (CVD) were studied. The two groups were well matched for traditional CVD risk factors. Serum creatinine (0.9±0.2 vs. 0.9±0.2mg/dl, P=0.96) and eGFR (96±22 vs. 96±24ml/min per 1.73m2, P=0.99) were similar between PLHIV and non-HIV, respectively. In PLHIV, eGFR inversely related to total severity of coronary plaque score (r=-0.27, P=0.002), total coronary segments with plaque (r=-0.21, P=0.005), calcified plaque segments (r=-0.15, P=0.045), and Agatston score (r=-0.21, P=0.006). Adjusting for total Framingham point score, BMI, and HIV parameters, eGFR remained significantly associated with calcified plaque and Agatston score in PLHIV. In HIV negative controls, eGFR did not correlate with calcified plaque (r=-0.20, P=0.10) or Agatston score (r=-0.13, P=0.29). Among PLHIV, those with eGFR less than 90ml/min per 1.73m2 demonstrated increased total severity of coronary plaque score compared with those with eGFR greater than or equal to 90, P=0.02). This relationship was stronger in PLHIV than the non-HIV group.Conclusion:Our data highlight a robust relationship between subclinical renal impairment and coronary artery disease among PLHIV. Further research is needed to understand the relationship between mild renal impairment and CVD in HIV.
KW - HIV
KW - cardiovascular disease
KW - coronary artery plaque
KW - estimated glomerular filtration rate
KW - renal impairment
UR - http://www.scopus.com/inward/record.url?scp=85058896614&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85058896614&partnerID=8YFLogxK
U2 - 10.1097/QAD.0000000000002055
DO - 10.1097/QAD.0000000000002055
M3 - Article
C2 - 30325774
AN - SCOPUS:85058896614
SN - 0269-9370
VL - 33
SP - 219
EP - 227
JO - AIDS
JF - AIDS
IS - 2
ER -