TY - JOUR
T1 - Carotid artery atherosclerosis is associated with mortality in HIV-positive women and men
AU - Hanna, David B.
AU - Moon, Jee Young
AU - Haberlen, Sabina A.
AU - French, Audrey L.
AU - Palella, Frank J.
AU - Gange, Stephen J.
AU - Witt, Mallory D.
AU - Kassaye, Seble
AU - Lazar, Jason M.
AU - Tien, Phyllis C.
AU - Feinstein, Matthew J.
AU - Kingsley, Lawrence A.
AU - Post, Wendy S.
AU - Kaplan, Robert C.
AU - Hodis, Howard N.
AU - Anastos, Kathryn
N1 - Publisher Copyright:
© 2018 Lippincott Williams and Wilkins. All rights reserved.
PY - 2018
Y1 - 2018
N2 - Objective: Among people with HIV, there are few long-Term studies of noninvasive ultrasound-based measurements of the carotid artery predicting major health events. We hypothesized that such measurements are associated with 10-year mortality in the Women s Interagency HIV Study (WIHS) and Multicenter AIDS Cohort Study (MACS), and that associations differ by HIV serostatus. Design: Nested cohort study. Methods: Participants without coronary heart disease underwent B-mode carotid artery ultrasound, with measurement of common carotid artery intima-media thickness (IMT); carotid artery plaque (focal IMT 1.5mm) at six locations; and Young s modulus of elasticity, a measure of arterial stiffness. We examined all-cause mortality using Cox models, controlling for demographic, behavioral, cardiometabolic, and HIV-related factors. Results: Among 1722 women (median age 40 years, 90% nonwhite, 71% HIV-positive) and 1304 men (median age 50, 39% nonwhite, 62% HIV-positive), 11% died during follow-up. Mortality was higher among HIV-positive women [19.9 deaths/1000 personyears, 95% confidence interval (CI) 14.7-28.8] than HIV-positive men (15.1/1000, 95% CI 8.3-26.8). In adjusted analyses, plaque was associated with mortality (hazard ratio 1.44, 95% CI 1.10-1.88) regardless of HIV serostatus, and varied by sex (among women, hazard ratio 1.06, 95% CI 0.74-1.52; among men; hazard ratio 2.19, 95% CI 1.41-3.43). The association of plaque with mortality was more pronounced among HIV-negative (hazard ratio 3.87, 95% 1.95-7.66) than HIV-positive participants (hazard ratio 1.35, 95% CI 1.00-1.84). Arterial stiffness was also associated with mortality (hazard ratio 1.43 for highest versus lowest quartile, 95% CI 1.02-2.01). Greater common carotid artery-IMT was not associated with mortality. Conclusion: Carotid artery plaque was predictive of mortality, with differences observed by sex and HIV serostatus.
AB - Objective: Among people with HIV, there are few long-Term studies of noninvasive ultrasound-based measurements of the carotid artery predicting major health events. We hypothesized that such measurements are associated with 10-year mortality in the Women s Interagency HIV Study (WIHS) and Multicenter AIDS Cohort Study (MACS), and that associations differ by HIV serostatus. Design: Nested cohort study. Methods: Participants without coronary heart disease underwent B-mode carotid artery ultrasound, with measurement of common carotid artery intima-media thickness (IMT); carotid artery plaque (focal IMT 1.5mm) at six locations; and Young s modulus of elasticity, a measure of arterial stiffness. We examined all-cause mortality using Cox models, controlling for demographic, behavioral, cardiometabolic, and HIV-related factors. Results: Among 1722 women (median age 40 years, 90% nonwhite, 71% HIV-positive) and 1304 men (median age 50, 39% nonwhite, 62% HIV-positive), 11% died during follow-up. Mortality was higher among HIV-positive women [19.9 deaths/1000 personyears, 95% confidence interval (CI) 14.7-28.8] than HIV-positive men (15.1/1000, 95% CI 8.3-26.8). In adjusted analyses, plaque was associated with mortality (hazard ratio 1.44, 95% CI 1.10-1.88) regardless of HIV serostatus, and varied by sex (among women, hazard ratio 1.06, 95% CI 0.74-1.52; among men; hazard ratio 2.19, 95% CI 1.41-3.43). The association of plaque with mortality was more pronounced among HIV-negative (hazard ratio 3.87, 95% 1.95-7.66) than HIV-positive participants (hazard ratio 1.35, 95% CI 1.00-1.84). Arterial stiffness was also associated with mortality (hazard ratio 1.43 for highest versus lowest quartile, 95% CI 1.02-2.01). Greater common carotid artery-IMT was not associated with mortality. Conclusion: Carotid artery plaque was predictive of mortality, with differences observed by sex and HIV serostatus.
KW - HIV
KW - arterial stiffness
KW - atherosclerosis
KW - intima-media thickness
KW - mortality
KW - plaque
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U2 - 10.1097/QAD.0000000000001972
DO - 10.1097/QAD.0000000000001972
M3 - Article
C2 - 30102657
AN - SCOPUS:85054466782
SN - 0269-9370
VL - 32
SP - 2393
EP - 2403
JO - AIDS
JF - AIDS
IS - 16
ER -