Study shows link between inflammatory biomarkers and prevalence of CAD in men infected with HIV -
A study of cardiac imaging headed by Hossein Bahrami, MD, PhD, assistant professor of cardiovascular medicine at the Keck School of medicine of the University of Southern California (USC), as well as researchers from Johns Hopkins University and five other institutions, has shown a correlation between biomarkers elevated inflammatory and an increased prevalence of coronary artery disease (CAD) in men infected with the human immunodeficiency virus (HIV). CAD is a narrowing of the arteries, probably due to the presence of calcified plaque and not calcified. The results were published in the Journal of the American Heart Association (JAHA) June 27, 2016.
The researchers examined nearly 925 men, 575 of whom were infected with HIV, the multicenter AIDS cohort study. The researchers used computed tomography (CT) angiography to detect subclinical signs of CAD, such as narrowed arteries and quantity, density and calcification of plaque. The participants were also measured to determine the presence of seven inflammatory biomarkers. The study, which was funded by the National Institutes of Health (NIH), is the largest imaging study by coronary CT on men with HIV to date.
"We found that men with HIV had higher levels of inflammatory biomarkers that men who are not infected," said Bahrami. "There was a strong independent association between the presence of these inflammatory biomarkers and subclinical CAD detected by the scanner. While this study certainly does not prove causation between these markers and heart disease, it is suggestive of a possible role that persistent inflammation (even in patients HIV who are under appropriate treatment) can play in increasing the risk of heart disease in these patients. "
individuals infected with HIV are at a two times higher risk of CAD by estimated compared to those who are not infected with HIV. The development of antiretroviral therapy has dramatically extended the life of people living with HIV. However, they are more prone to chronic diseases, such as cardiovascular disease and CAD, and they present at a young age. These factors combined have done research on the treatment of chronic diseases in men with HIV even more important.
The CT imaging was crucial for this study, researchers were able to detect subclinical CAD in a population younger rather than waiting participants had clinical symptoms. In addition, the researchers used a broader set of inflammatory markers than in previous studies, which provides more information about the inflammatory pathways involved and possible causes of inflammation.
"Inflammation has recently been investigated as a possible reason for the chronic heart disease," said Bahrami. "Confirmation of the relationship between HIV-related inflammation and the marked increase in CAD in men infected with HIV enables us to move forward in our efforts to better manage the health of these patients according to their specific medical needs. "
in the ongoing research efforts at the Keck School, Bahrami and team are also using imaging cardiac magnetic resonance imaging (MRI) to study changes in the heart muscle, as well as details of the function of the coronary artery in men affected by HIV. This advanced form of imaging evaluating several features of the heart that could not be assessed with cardiovascular CT. This ongoing project is important because patients with HIV appear to have an even higher risk of abnormalities in the heart muscles compared to their increased risk of CHD. The research Bahrami hope to illuminate what causes HIV-related inflammation, as well as to identify specific pathways involved and the best ways of treating or managing heart disease in HIV patients.
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