HIV Infection and Subclinical Coronary Atherosclerosis

Letters16 December 2014HIV Infection and Subclinical Coronary AtherosclerosisWendy S. Post, MD, MS, Richard T. George, MD, and Matthew Budoff, MDWendy S. Post, MD, MSFrom Johns Hopkins University School of Medicine, Baltimore, Maryland; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California., Richard T. George, MDFrom Johns Hopkins University School of Medicine, Baltimore, Maryland; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California., and Matthew Budoff, MDFrom Johns Hopkins University School of Medicine, Baltimore, Maryland; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5033-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Chartrand-Lefebvre and colleagues for their insightful comments about our article, which showed that HIV-infected men had a greater prevalence of and more extensive noncalcified plaque than uninfected men in MACS (Multicenter AIDS Cohort Study). We agree that the noninvasive assessment plaque vulnerability with CT scanning may further elucidate potential mechanisms that place HIV-infected persons at increased risk for acute myocardial infarction. Before plaque rupture, the degree of luminal stenosis is frequently less than 50% and therefore would not lead to symptoms or abnormal results on stress testing (1). Recent advances in the analysis of coronary ...References1. Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, et al; PROSPECT Investigators. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011;364:226-35. [PMID: 21247313] doi:10.1056/NEJMoa1002358 CrossrefMedlineGoogle Scholar2. Nakazato R, Shalev A, Doh JH, Koo BK, Dey D, Berman DS, et al. Quantification and characterisation of coronary artery plaque volume and adverse plaque features by coronary computed tomographic angiography: a direct comparison to intravascular ultrasound. Eur Radiol. 2013;23:2109-17. [PMID: 23553587] doi:10.1007/s00330-013-2822-1 CrossrefMedlineGoogle Scholar3. Motoyama S, Sarai M, Harigaya H, Anno H, Inoue K, Hara T, et al. Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome. J Am Coll Cardiol. 2009;54:49-57. [PMID: 19555840] doi:10.1016/j.jacc.2009.02.068 CrossrefMedlineGoogle Scholar4. Zanni MV, Abbara S, Lo J, Wai B, Hark D, Marmarelis E, et al. Increased coronary atherosclerotic plaque vulnerability by coronary computed tomography angiography in HIV-infected men. AIDS. 2013;27:1263-72. [PMID: 23324657] doi:10.1097/QAD.0b013e32835eca9b CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Wendy S. Post, MD, MS; Richard T. George, MD; Matthew Budoff, MDAffiliations: From Johns Hopkins University School of Medicine, Baltimore, Maryland; and Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1754. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAssociations Between HIV Infection and Subclinical Coronary Atherosclerosis Wendy S. Post , Matthew Budoff , Lawrence Kingsley , Frank J. Palella Jr. , Mallory D. Witt , Xiuhong Li , Richard T. George , Todd T. Brown , and Lisa P. Jacobson HIV Infection and Subclinical Coronary Atherosclerosis Carl Chartrand-Lefebvre , Madeleine Durand , and Cécile Tremblay Metrics Cited byManagement of hypercholesterolemia in individuals living with HIV/AIDSDyslipidemia in Special Populations, the Elderly, Women, HIV, Chronic Kidney Disease and ESRD, and Minority GroupsDefining the Link between Pulmonary and Cardiovascular Disease for People Living with Human Immunodeficiency VirusAssociations between lipids and subclinical coronary atherosclerosisPresence, Characteristics, and Prognostic Associations of Carotid Plaque Among People Living With HIVUtility of 2013 American College of Cardiology/American Heart Association Cholesterol Guidelines in HIV-Infected Adults With Carotid AtherosclerosisHIV, highly active antiretroviral therapy and the heart: a cellular to epidemiological reviewChlamydia pneumoniae acute liver infection affects hepatic cholesterol and triglyceride metabolism in miceAtherosclerosis in HIV patients: A different disease or more of the same? 16 December 2014Volume 161, Issue 12Page: 923-924KeywordsAIDSAngiographyCohort studiesComputed axial tomographyCoronary arteriesDisclosureHIVHIV infectionsStable coronary artery diseaseStenosis ePublished: 16 December 2014 Issue Published: 16 December 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...