TY - JOUR
T1 - Coronary artery calcification and plaque characteristics in people living with hiv
T2 - A systematic review and meta-analysis
AU - Soares, Cullen
AU - Samara, Amjad
AU - Yuyun, Matthew F.
AU - Echouffo-Tcheugui, Justin B.
AU - Masri, Ahmad
AU - Samara, Ahmad
AU - Morrison, Alan R.
AU - Lin, Nina
AU - Wu, Wen Chih
AU - Erqou, Sebhat
N1 - Funding Information:
This research reported/outlined here was funded by the Department of Veterans Affairs, Veterans Health Administration, and VISN-1 Career Development award to Dr Erqou. Dr Erqou was also supported by Providence/Boston Center for Aids Research (P30 AI042853), the Rhode Island Foundation, and Lifespan Cardiovascular Institute. This work is partially supported (investigator’s time, effort, and publication cost) by the Department of Veterans Affairs Health Service Research and Development Merit Review grant IRP 20-003 (Dr Wu). The work is also supported (investigator’s time and effort) by a Research Project Grant from the National Institutes of Health; the National Heart, Lung, and Blood Institute R01HL139795 (Dr Morrison), an Institutional Development Award from the National Institutes of Health National Institute of General Medical Sciences P20GM103652 (Dr Morrison), and Career Development Award 7IK2BX002527 from the Department of Veterans Affairs Biomedical Laboratory Research and Development Program (Dr Morrison). Drs Yuyun, Morrison, Wu, and Erqou are employees of the Department of Veterans Affair. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
Publisher Copyright:
© 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2021/10/5
Y1 - 2021/10/5
N2 - BACKGROUND: Studies have reported that people living with HIV have higher burden of subclinical cardiovascular disease, but the data are not adequately synthesized. We performed meta-analyses of studies of coronary artery calcium and coronary plaque in people living with HIV. METHODS AND RESULTS: We performed systematic search in electronic databases, and data were abstracted in standardized forms. Study-specific estimates were pooled using meta-analysis. 43 reports representing 27 unique studies and involving 10 867 participants (6699 HIV positive, 4168 HIV negative, mean age 52 years, 86% men, 32% Black) were included. The HIV-positive participants were younger (mean age 49 versus 57 years) and had lower Framingham Risk Score (mean score 6 versus 18) compared with the HIV-negative participants. The pooled estimate of percentage with coronary artery calcium >0 was 45% (95% CI, 43%–47%) for HIV-positive participants, and 52% (50%–53%) for HIV-negative participants. This difference was no longer significant after adjusting for difference in Framingham Risk Score between the 2 groups. The odds ratio of coronary artery calcium progression for HIV-positive versus-negative participants was 1.64 (95% CI, 0.91–2.37). The pooled estimate for prevalence of noncalcified plaque was 49% (95% CI, 47%–52%) versus 20% (95% CI, 17%–23%) for HIV-positive versus HIV-negative participants, respectively. Odds ratio for noncalcified plaque for HIV-positive versus-negative participants was 1.23 (95% CI, 1.08–1.38). There was significant heterogeneity that was only partially explained by available study-level characteristics. CONCLUSIONS: People living with HIV have higher prevalence of noncalcified coronary plaques and similar prevalence of coronary artery calcium, compared with HIV-negative individuals. Future studies on coronary artery calcium and plaque progression can further elucidate subclinical atherosclerosis in people living with HIV.
AB - BACKGROUND: Studies have reported that people living with HIV have higher burden of subclinical cardiovascular disease, but the data are not adequately synthesized. We performed meta-analyses of studies of coronary artery calcium and coronary plaque in people living with HIV. METHODS AND RESULTS: We performed systematic search in electronic databases, and data were abstracted in standardized forms. Study-specific estimates were pooled using meta-analysis. 43 reports representing 27 unique studies and involving 10 867 participants (6699 HIV positive, 4168 HIV negative, mean age 52 years, 86% men, 32% Black) were included. The HIV-positive participants were younger (mean age 49 versus 57 years) and had lower Framingham Risk Score (mean score 6 versus 18) compared with the HIV-negative participants. The pooled estimate of percentage with coronary artery calcium >0 was 45% (95% CI, 43%–47%) for HIV-positive participants, and 52% (50%–53%) for HIV-negative participants. This difference was no longer significant after adjusting for difference in Framingham Risk Score between the 2 groups. The odds ratio of coronary artery calcium progression for HIV-positive versus-negative participants was 1.64 (95% CI, 0.91–2.37). The pooled estimate for prevalence of noncalcified plaque was 49% (95% CI, 47%–52%) versus 20% (95% CI, 17%–23%) for HIV-positive versus HIV-negative participants, respectively. Odds ratio for noncalcified plaque for HIV-positive versus-negative participants was 1.23 (95% CI, 1.08–1.38). There was significant heterogeneity that was only partially explained by available study-level characteristics. CONCLUSIONS: People living with HIV have higher prevalence of noncalcified coronary plaques and similar prevalence of coronary artery calcium, compared with HIV-negative individuals. Future studies on coronary artery calcium and plaque progression can further elucidate subclinical atherosclerosis in people living with HIV.
KW - Calcium score
KW - Cardiovascular disease
KW - Coronary artery calcium
KW - Coronary plaque
KW - Human immunodeficiency virus
KW - Subclinical atherosclerosis
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U2 - 10.1161/JAHA.120.019291
DO - 10.1161/JAHA.120.019291
M3 - Article
C2 - 34585590
AN - SCOPUS:85118097183
SN - 2047-9980
VL - 10
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 19
M1 - e019291
ER -