Key result
Positive SPECT MPI plus exercise test linked to ~4-fold higher odds of cardiac events in HIV.
Why the study?
The relevance of SPECT MPI combined with exercise testing for detecting silent coronary heart disease and predicting cardiac events in asymptomatic people with HIV on ART was unclear.
Does SPECT myocardial perfusion imaging combined with exercise testing detect baseline silent coronary heart disease and predict incident cardiac events in asymptomatic people with HIV?
Observational (n=475)
No
Does SPECT myocardial perfusion imaging combined with exercise testing detect baseline silent coronary heart disease and predict incident cardiac events in asymptomatic people with HIV?
Odds Ratio: 4 (95% CI 1.91–8.35)
p-value: p=< 0.001
SPECT MPI combined with exercise testing can effectively detect silent coronary heart disease and predict future incident cardiac events in asymptomatic individuals with HIV on antiretroviral therapy.
May support targeted evaluation in asymptomatic HIV; leaves open whether routine combined testing improves outcomes.
Objective: To evaluate the relevance of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) combined with exercise testing, performed in asymptomatic people with HIV receiving effective antiretroviral therapy (ART), for detecting baseline silent coronary heart disease (SCHD) and predicting incident cardiac events. Design: Retrospective observational study conducted between November 2015 and July 2024 at Saint-Louis Hospital, Paris. Methods: We screened people with HIV with no history of coronary artery disease for SCHD using MPI combined with exercise testing. Patients with abnormal findings underwent coronary angiography. Baseline SCHD was defined as the presence of significant coronary stenosis confirmed by coronary angiography. Incident cardiac events during follow-up included incident SCHD, myocardial infarction, chest pain associated with significant coronary stenosis, and sudden death. Baseline risk factors associated with SCHD and cardiac events were assessed using univariate and multivariate analyses. Results: A total of 475 people with HIV were analyzed, with a median follow-up of 6 years. The median age was 56 years, 87.8% were male, 58.1% were current or ex-smokers, and 29.9% were on statins. The baseline prevalence of SCHD was 2.1% [95% confidence interval (CI): 1.1–4]. During follow-up, the incidence of cardiac events was 1.2 per 100 person-years (95% CI: 0.8–1.7). Only a combined positive MPI and exercise testing was associated with a significantly increased risk of SCHD and cardiac events [adjusted odds ratio (aOR) 4.0; 95% CI: 1.91–8.35; P < 0.001]. Conclusion: SPECT MPI combined with exercise testing can detect SCHD and may help identify people with HIV at increased cardiovascular risk.
No takes yet. Share an insight, caveat, or question.
Cresta et al. (2026) conducted an observational in HIV without history of coronary artery disease (n=475). Combined positive SPECT MPI and exercise testing was evaluated on Silent coronary heart disease (SCHD) and cardiac events (aOR 4.0, 95% CI 1.91-8.35, p=< 0.001). A combined positive SPECT MPI and exercise test in people with HIV was associated with an increased risk of silent coronary heart disease and cardiac events (aOR 4.0; 95% CI 1.91-8.35; P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: