他汀类药物对接受抗逆转录病毒治疗的HIV+患者冠状动脉钙分布、质量和体积评分的影响及其与免疫激活的关系

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
Antiviral Therapy Pub Date : 2020-01-01 DOI:10.3851/IMP3389
Jerry Lipinski, Seunghee Margevicius, Mark D Schluchter, David L Wilson, Grace A McComsey, Chris T Longenecker
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引用次数: 0

摘要

背景:在接受抗逆转录病毒治疗(ART)的HIV感染者(PWH)中,炎症与全心冠状动脉钙化(CAC)有关;然而,先前的研究没有评估钙的分布或分离质量与体积评分,这与一般人群的临床事件有差异相关。与体积相比,他汀类药物对CAC质量的影响可能更大。方法:147例PWH按1:1随机分为瑞舒伐他汀10 mg组和安慰剂组,随访96周。我们重新分析了第0、48和96周的冠状动脉钙扫描,以确定质量和体积评分以及CAC弥散度的测量。混合效应模型和广义估计方程用于检验CAC与治疗和生物标志物的纵向关联。结果:入组时的中位年龄为46岁;78%是男性,68%是非裔美国人。中位数CD4+为613,半数患者使用蛋白酶抑制剂。随机接受他汀类药物治疗与质量评分、体积评分、受累性血管数量或弥漫性指数的变化无关(均P>0.1)。可溶性CD14与CAC的存在相关(P=0.05),与受检血管数量相关(P=0.07)。结论:在接受抗逆转录病毒治疗的PWH中,中等强度瑞舒伐他汀在96周内对CAC的体积、质量或区域分布似乎没有显著影响。我们扩展了以前的横断面观察,表明可溶性CD14随时间与全心CAC相关,且独立于年龄和收缩压。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Statin effect on coronary calcium distribution, mass and volume scores and associations with immune activation among HIV+ persons on antiretroviral therapy.

Background: Inflammation has been associated with whole heart coronary artery calcification (CAC) among people with HIV (PWH) on antiretroviral therapy (ART); however, prior studies have not evaluated the distribution of calcium or separated mass versus volume scores, which are differentially associated with clinical events in the general population. Statins may also have a greater effect on CAC mass compared with volume.

Methods: 147 PWH were randomized 1:1 to rosuvastatin 10 mg or placebo and followed for 96 weeks. We re-analysed coronary calcium scans from 0, 48 and 96 weeks to determine mass and volume scores and measures of CAC diffusivity. Mixed effects models and generalized estimating equations were used to examine longitudinal associations of CAC with treatment and biomarkers.

Results: Median age at study entry was 46 years; 78% were male and 68% African American. Median CD4+ was 613 and half were on protease inhibitors. Randomization to statin therapy was not associated with a change in mass score, volume score, number of involved vessels or diffusivity index (all P>0.1). Soluble CD14 was associated with the presence of CAC (P=0.05) and borderline associated with number of involved vessels (P=0.07) across all three time points.

Conclusions: In PWH on ART, moderate intensity rosuvastatin does not appear to have a significant effect on volume, mass or regional distribution of CAC over 96 weeks. We extend previous cross-sectional observations to show that soluble CD14 is associated with whole heart CAC over time and independently of age and systolic blood pressure.

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来源期刊
Antiviral Therapy
Antiviral Therapy 医学-病毒学
CiteScore
2.60
自引率
8.30%
发文量
35
审稿时长
4-8 weeks
期刊介绍: Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.
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