The association of premature atherosclerosis with ischemic stroke in young people with HIV in Lusaka, Zambia

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-09-03 DOI:10.1016/j.jstrokecerebrovasdis.2025.108445

Stanley Zimba , Owen Ngalamika , Emmanuel Mukambo , Theresa Shankanga , Bwalya Mulenga , Mike Chisha , Violet Kayamba , Lloyd Mulenga , Omar Siddiqi , Owen A. Ross , Masharip Atadzhanov , Deanna Saylor

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引用次数: 0

Abstract

Background

Premature atherosclerosis has been observed among people with HIV (PWH) with high risk of cerebrovascular disease. The aim of this study was to evaluate premature atherosclerosis in young PWH with and without ischemic stroke.

Methods

We conducted a prospective case-control study at the University Teaching Hospital in Lusaka, Zambia between March 2022 and October 2024, comparing young PWH with non-cardioembolic ischemic stroke (cases) with PWH without a history of stroke (controls) matched (1:2) for age, sex and race. Premature atherosclerosis was assessed using a Mindray DC-40, linear probe 8-13 MHz high resolution B-mode ultrasound to measure carotid intima-media thickness (cIMT; abnormal≥0.70 mm) and pulse wave velocity (PWV; abnormal≥10.00m/s).

Results

We analyzed results for 50 cases and 100 controls. Compared to controls, cases were more likely to have traditional stroke risk factors such as hypertension (42 % vs. 1 %, p=0.001); shorter duration from HIV diagnosis (<3 months: 16 % vs. 1 %, p=0.001);and markers of atherosclerotic disease, including higher PWV [10.89 (9.99-12.15) m/s vs. 8.97 (8.16 - 9.54) m/s, p<0.001] and increased cIMT [0.79 (0.70-0.99) mm vs. 0.63 (0.58 - 0.67) mm, p<0.001]. Poor WHO HIV clinical stage (stage 3: aOR 58, 95 % CI 1-3213, p=0.04), higher PWV (aOR 8.7, 95 % CI 2.0-38.1, p=0.004) and urban residence (aOR 25.5, 95 % CI 1.6-413.4, p=0.02) were independently associated with ischemic stroke in multivariable analyses.

Conclusion

In this cohort of young-onset HIV-associated non-cardioembolic ischemic stroke, premature atherosclerosis, as indicated by higher PWV, was independently associated with stroke.

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早发动脉粥样硬化与赞比亚卢萨卡艾滋病毒感染者缺血性中风的关系

背景：早发动脉粥样硬化已在高危的HIV感染者（PWH）中被观察到。本研究的目的是评估年轻PWH伴和不伴缺血性中风的过早动脉粥样硬化。方法：我们于2022年3月至2024年10月在赞比亚卢萨卡大学教学医院进行了一项前瞻性病例对照研究，比较年轻PWH与无卒中史的PWH（对照组）在年龄、性别和种族上匹配（1:2）的非心脏栓塞性缺血性卒中（病例）。采用迈瑞DC-40，线性探头8-13MHz高分辨率b型超声测量颈动脉内膜-中膜厚度（cIMT，异常≥0.70mm）和脉搏波速度（PWV，异常≥10.00m/s）评估过早动脉粥样硬化。结果：我们分析了50例病例和100例对照的结果。与对照组相比，病例更有可能有传统的卒中危险因素，如高血压（42%比1%，p=0.001）；结论：在这个年轻发病的HIV相关非心源性缺血性卒中队列中，高PWV所表明的过早动脉粥样硬化与卒中独立相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.