The Evaluation Of Subclinical Coronary Atherosclerosis Of Different Therapy Stages In Middle-aged HIV(+) Chinese Adults

ObjectiveIt is demonstrated that HIV(+)patients have a higher risk for cardiovascular disease,mainly due to HIV infection itself and medication side effect in addition to traditional risk factors.This study is aimed to determine whether the routinely long-term medication treatment using HAART has an impact on total CAC score and plaque formation.MethodsA total number of 98 HIV(+)patients was enrolled in the study.According to the duration of HAART mediation treatment,the patients were divided into three groups: A(less than 2 years),B(2 to 5 years)and C(more than 5 years).ResultsThere were 34 patients for group A,31 for group B and 33 for group C,and no significant differences in demographic data and risk factors of cardiovascular disease were found between groups.The prevalence of patients with CAC(Agatston score>0)were 29.4% among in group A,48.3% in group B and 54.5% in group C.The median Agatston CCS for group A was 75 [25-75 th percentile: 0-59].As for group B and group C,the median value was 167 [25-75 th percentile: 0-59] and 123 [25-75 th percentile: 0-73] respectively,there was no significant difference found between groups.The prevalence of total plaque,calcified plaque,non-calcified plaque and mixed plaque was 44.1%,32.4%,32.4% and 17.6% for group A,58.0%,45.2%,35.4% and 35.5% for group B,and 75.8%,45.5%,66.7% and 45.5% for group C respectively.There was significant difference in the prevalence of total coronary plaque(p=0.031),non-calcified plaque(p=0.008)and borderline significant in the prevalence of mixed plaque(p=0.048).The difference of the median total coronary plaque and segments involvement with plaque per patient was statistically significant between groups(p=0.047,p=0.009).The prevalence of a coronary artery stenosis >50% was no longer statistically significant between groups(p=0.095).After adjusting for demographic,laboratory and clinical factors,logistic regression analysis revealed that exposure to HAART was independently associated with the presence of coronary plaques.ConclusionIt is indicated by this study that the longer duration of HAART medication therapy the patients received,the higher level of any coronary plaque,non-calcified plaque and mixed plaque would happen,and it may have no effect on total CAC score or calcified plaque.However,larger sample is needed for further validation.