Key result
HIV-infected men had greater epicardial adipose tissue volume than HIV-uninfected men, which was associated with the presence of coronary artery plaque.
Why the study?
Is HIV infection and antiretroviral therapy duration associated with increased epicardial fat and subclinical coronary atherosclerosis in men?
Cross-Sectional (n=932)
Is HIV infection and antiretroviral therapy duration associated with increased epicardial fat and subclinical coronary atherosclerosis in men?
HIV infection and duration of antiretroviral therapy are associated with increased epicardial fat volume, which correlates with subclinical coronary atherosclerosis, suggesting a potential mechanism for increased cardiovascular risk in this population.
Answers are grounded in this paper and cite their sources.
Epicardial fat increase in HIV may flag subclinical plaque risk; hypothesis-generating and requires prospective validation before clinical use.
OBJECTIVE: Cytokines released by epicardial fat are implicated in the pathogenesis of atherosclerosis. HIV infection and antiretroviral therapy have been associated with changes in body fat distribution and coronary artery disease. We sought to determine whether HIV infection is associated with greater epicardial fat and whether epicardial fat is associated with subclinical coronary atherosclerosis. DESIGN: We studied 579 HIV-infected and 353 HIV-uninfected men aged 40-70 years with noncontrast computed tomography to measure epicardial adipose tissue (EAT) volume and coronary artery calcium (CAC). Total plaque score (TPS) and plaque subtypes (noncalcified, calcified, and mixed) were measured by coronary computed tomography angiography in 706 men. METHODS: We evaluated the association between EAT and HIV serostatus, and the association of EAT with subclinical atherosclerosis, adjusting for age, race, and serostatus and with additional cardiovascular risk factors and tested for modifying effects of HIV serostatus. RESULTS: HIV-infected men had greater EAT than HIV-uninfected men (P=0.001). EAT was positively associated with duration of antiretroviral therapy (P=0.02), specifically azidothymidine (P<0.05). EAT was associated with presence of any coronary artery plaque (P=0.006) and noncalcified plaque (P=0.001), adjusting for age, race, serostatus, and cardiovascular risk factors. Among men with CAC, EAT was associated with CAC extent (P=0.006). HIV serostatus did not modify associations between EAT and either CAC extent or presence of plaque. CONCLUSION: Greater epicardial fat volume in HIV-infected men and its association with coronary plaque and antiretroviral therapy duration suggest potential mechanisms that might lead to increased risk for cardiovascular disease in HIV.
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Brener et al. (2014) conducted a cross-sectional in HIV infection and coronary atherosclerosis (n=932). HIV infection vs. HIV-uninfected men was evaluated on Epicardial adipose tissue (EAT) volume (p=0.001). HIV-infected men had greater epicardial adipose tissue volume than HIV-uninfected men, which was associated with the presence of coronary artery plaque.
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