Paper
Saturday, July 24, 2004
Subclinical Coronary Artery Disease in HIV-Infected Men Aged 40-49 Treated With Protease Inhibitors
F. Patrick Robinson, PhD, RN, ACRN, College of Nursing, Department of Medical-Surgical Nursing, College of Nursing, Department of Medical-Surgical Nursing, University of Illinois at Chicago, Chicago, IL, USA
| Learning Objective #1: Describe the impact protease inhibitor therapy has on cardiovascular risk factors |
| Learning Objective #2: Discuss the difference in coronary artery calcium scores between HIV-infected, protease inhibitor-treated men and healthy controls |
Objective: The purpose of this study was to examine the extent of subclinical coronary artery disease (CAD) measured by coronary artery calcium (CAC) scores in HIV-infected men treated with protease inhibitors (PI) compared to controls. Design: Case-control study. Sample: A convenience sample of 18 HIV-infected men aged 40-49 years who had been on a stable PI-containing antiretroviral regimen for at least 12 months were recruited as cases. Fifty-four (54) age and gender-matched controls were randomly selected (3 controls for each case) from an existing database of 9,178 men in their 40s who self-referred for CAC screening and who were free of known CAD at the time of screening. Variables: Electron Beam Tomography (EBT) is a sensitive, noninvasive method for quantifying CAC. Up to 40 transaxial slices of the coronary artery tree were obtained and calcium plaques were quantified based on area and density. The CAC score was the sum of all lesions across the major coronary arteries. Methods: Identical scanning procedures were used on both cases and controls. The CAC scores were coded as above or below the age-specific 90th percentile of our existing healthy database (4,238 men aged 40-44 and 4,940 men aged 45-49). Findings: The result of the chi-square test indicated a significantly higher number of cases above the 90th percentile of age-specific CAC scores compared to controls (X2=9.52, p=.002). A moderate (phi=.36), but highly significant (p=.002) association was found between cases and a CAC >90th percentile. Conclusions: HIV infected men aged 40-49 treated with a PI –containing antiretroviral regimens had a higher incidence of heightened (defined as > 90th percentile of expected) subclinical CAD as compared to healthy controls. Implications: These findings suggest the need for research related to interventions aimed at reducing CAD risk in this patient population.
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Sigma Theta Tau International
July 22-24, 2004