Vitamin D deficiency is associated with silent coronary artery disease in cardiovascularly asymptomatic african americans with HIV infection

Hong Lai, Gary Gerstenblith, Elliot K. Fishman, Jeffrey Brinker, Thomas Kickler, Wenjing Tong, Sundeepan Bhatia, Tai Hong, Shaoguang Chen, Ji Li, Barbara Detrick, Shenghan Lai

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Growing evidence suggests that vitamin D deficiency Is associated with clinical coronary artery disease (CAD). The relationship between vitamin D deficiency and subclinical CAD in HIV-infected individuals is not well-characterized.Methods.Computed tomographic (CT) coronary angiography was performed using contrast-enhanced 64-slice multidetector CT imaging, and vitamin D levels and the presence of traditional and novel risk factor for CAD were obtained in 674 HIV-infected African American (AA) participants aged 25-54 years in Baltimore, MD, without symptoms/clinical evidence of CAD.Results.The prevalence of vitamin D deficiency (25-hydroxy vitamin D <10 ng/mL) was 20.0 (95 confidence interval [CI], 16.9-23.1). Significant (≥50) coronary stenosis was present in 64 (9.5) of 674 participants. Multiple logistic regression analysis revealed that male gender (adjusted odds ratio [OR], 2.19; 95 CI, 1.17-4.10), diastolic BP ≥85 mmHg (adjusted OR: 1.94, 95 CI: 1.02-3.68), low-density lipoprotein cholesterol ≥100 mg/dL (adjusted OR, 1.95; 95 CI, 1.13-3.36), cocaine use for ≥15 years (adjusted OR, 1.77; 95 CI, 1.01-3.10), use of antiretroviral therapies for ≥6 months (adjusted OR, 2.26; 95 CI, 1.17-4.36), year of enrollment after 2005 (adjusted ORs for 2006-2007, 2008-2009, and 2010 were 0.32 [95 CI, 0.13-0.76], 0.26 [95 CI, 0.12-0.56], and 0.32 (95 CI, 0.15-0.65], respectively), and vitamin D deficiency (adjusted OR, 2.28; 95 CI, 1.23-4.21) were independently associated with significant coronary stenosis.Conclusions.Both vitamin D deficiency and silent CAD are prevalent in HIV-infected AAs. In addition to management of traditional CAD risk factors and substance abuse, vitamin D deficiency should be evaluated in HIV-infected AAs. These data support the conduct of a prospective trial of vitamin D in this high-risk patient population.

Original languageEnglish (US)
Pages (from-to)1747-1755
Number of pages9
JournalClinical Infectious Diseases
Volume54
Issue number12
DOIs
StatePublished - Jun 15 2012

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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