The Evaluation Of Coronary Artery Plaques,stenosis And Impact Factors In HIV-infected Patients

Part I : Evaluation of coronary artery plaques and stenosis in HIV-infected patientsObjective:This study was designed to evaluate the coronary CTA findings of HIV-infected patients and HIV-uninfected patients,and further analyze the coronary artery plaques and stenosis.Materials and methods:21 HIV-infected patients and 32 HIV-uninfected patients in our hospital were collected form January 2016 to January 2017.All patients were scanned with the dual-source CT.The inclusion criteria: the function of heart,lung and kidney are good.Not be allergy to contrast agents.No history of heart surgery.The exclusion criteria: the function of heart,lung and kidney are worse.Somebody is unconscious who can't cooperate with the examination.Be allergy to contrast agents.History of heart surgery.Results:21 HIV-infected patients and 32 HIV-uninfected patients were examined with the coronary CTA.According to the 15 segments of American Heart Association,they had 297 segments and 453 segments,respectively.The mean age of HIV-infected patients and HIV-uninfected patients were 50.9±9.5 and 54.3±8.9,respectively.The probability of coronary artery plaques in HIV-infected patients and HIV-uninfected patients were 15.6% and 10.6%,respectively.The mean segments of them were 2.2 and 1.5,and p=0.048.The probability of soft plaques in HIV-infected patients and HIV-uninfected patients were 8.8% and 4.0%,respectively.The mean segments of them were 1.2 and 0.6,and p=0.006.There was no big difference in the probability of mixed plaques between HIV-infected patients and HIV-uninfected patients.HIV-infected patients and HIV-uninfected patients both had more soft plaques than calcified plaques and mixed plaques.The probability of plaques in the proximal arterial segments in HIV-infected patients and HIV-uninfected patients were 71.% and 72.6%,respectively.The probability of obvious coronary artery stenosis(stenosis?50%)in HIV-infected patients and HIV-uninfected patients were 7/21(33.3%)and 2/32(6.3%),respectively,and p=0.028.In the seven HIV-infected patients with obvious coronary stenosis,the probability of obvious coronary stenosis was 9/21.The probability of obvious coronary stenosis in right coronary artery,left anterior descending artery and left circumflex coronary artery were 1/9,6/9 and 2/9.The probability of different coronary plaques in HIV-infected patients with or without obvious coronary stenosis were the same.In the seven HIV-infected patients with obvious coronary stenosis,all had at least 2 segments with coronary stenosis.But in the 14 HIV-infected patients without obvious coronary stenosis,the proportion was 35.7%,and p=0.006.Conclusions: The probability of coronary artery plaques,especially soft plaques,in HIV-infected patients are higher than HIV-uninfected patients.The probability of mixed plaques in HIV-infected patients and HIV-uninfected patients are the same.The probability of obvious coronary artery stenosis in HIV-infected patients are higher than HIV-uninfected patients.Part II: Research on the impact factors of coronary artery plaques in HIV-infected patientsObjective:Through analyzing the impact factors of coronary artery plaques in HIV-infected patients and finding the biggest impact factor,to prevent in advance and treat in time.Materials and methods:21 HIV-infected patients in our hospital were collected.They all were examined with the coronary CTA.Patients' basic information and laboratory examination results were recorded.According to the manifestation of CTA,the HIV patients were divided to two groups.Results:HIV-infected patients with coronary plaques had higher current CD4+T cell count(p=0.002),compared with no plaque group.Lower current CD4+T cell count was associated with increased coronary plaques numbers in HIV-infected patients,and p= 0.001.There was no association in age,gender,BMI,hypertension,diabetes,smoking,low density lipoprotein,high density lipoprotein,triglyceride,total cholesterol,duration of antiretroviral therapy and nadir CD4+T cell count with coronary plaque numbers.Conclusion:Among HIV-infected patients,with coronary plaques group had higher current CD4+T cell count(p=0.002)than no plaque group.Current CD4+T cell count is negatively associate with the coronary artery plaque numbers.There is no association in other factors with the coronary artery plaque numbers,which needs further research with more HIV-infected patients.