HIV infection and/or antiretroviral therapy may increase the risk of subclinical coronary atherosclerosis. However, patients with chronic kidney disease (CKD) and those without IV access cannot undergo contrast-enhanced coronary CT angiography (CCTA). This study was to explore the relationship between cardiac troponin T (cTnT) levels and the extent of coronary plaque burden, as assessed by CCTA in those with HIV infection. Between June and September 2017, 58 HIV-infected participants were recruited and underwent contrast-enhanced CCTA. cTnT was measured with the Elecsys Troponin T Gen 5 STAT assay, and noncalcified plaque burden was quantified using coronary plaque analysis. Robust regression model was employed to perform primary statistical analysis. Univariate robust regression analysis indicated that male gender, cardiovascular risk score defined by the 2013 ACC/AHA cardiovascular risk score algorithm, and cTnT levels were significantly associated with noncalcified plaque volume index (NCPI). Final robust regression analyses showed that only cTnT (log scale) was independently associated with the NCPI (regression coefficient: 0.0453 with 95% CI: 0.0151, 0.0755, p = 0.003). These results of this study suggest that cTnT may be a promising marker for coronary plaque burden, especially in patients with HIV-associated CKD or without IV access.
Rodriguez-PenneyATIudicelloJERiggsPKet al.
Co-morbidities in persons infected with HIV: increased burden with older age and negative effects on health-related quality of life. AIDS Patient Care STDS2013;
27: 5–16.
2.
MengQLimaJACLaiHet al.
Coronary artery calcification, atherogenic lipid changes and increased erythrocyte volume in HIV-1 infected participants treated with protease inhibitors. Am Heart J2002;
144: 642–648.
3.
MengQLimaJACLaiHet al.
Use of HIV protease inhibitors is associated with left ventricular morphologic changes and diastolic dysfunction. J Acquir Immune Defic Syndr2002;
30: 306–310.
4.
LaiSLaiHCelentanoDDet al.
Factors associated with accelerated atherosclerosis in HIV-1–infected persons treated with protease inhibitors. AIDS Patient Care STDS2003;
17: 211–219.
LaiSFishmanEKLaiHet al.
Long-term cocaine use and antiretroviral therapy are associated with silent coronary artery disease in cardiovascularly asymptomatic African Americans with HIV infection. Clin Infect Dis2008;
46: 600–610.
7.
LaiSBartlettJLaiHet al.
Long-term combination antiretroviral therapy is associated with the risk of coronary plaques in African Americans with HIV infection. AIDS Patient Care STDs2009;
23: 815–824.
8.
LaiHMooreRCelentanoDDet al. HIV infection itself may not be associated with subclinical coronary artery disease among African Americans without cardiovascular symptoms. J Am Heart Assoc 2016; 5(3):e002529. doi: 10.1161/JAHA.115.002529.
9.
LaiSGerstenblithGMooreRDet al.
Cocaine use may modify HIV/ART-associated myocardial steatosis and hepatic steatosis. Drug Alcohol Depend2017;
177: 84–92.
10.
FitchKVDeFilippiCChristensonRet al.
Subclinical myocyte injury, fibrosis and strain in relationship to coronary plaque in asymptomatic HIV-infected individuals. AIDS2016;
30: 2205.
11.
KrugerRSchutteAEMelsCMCet al.
Cardiac troponin T as early marker of subclinical cardiovascular deterioration in black hypertensive women. Heart Lung Circ2017;
26: 825–832.
12.
OemrawsinghRMChengJMGarcía-GarcíaHMet al.
High-sensitivity troponin T in relation to coronary plaque characteristics in patients with stable coronary artery disease; results of the ATHEROREMO-IVUS study. Atherosclerosis2016;
247: 135–141.
13.
KorosoglouGLehrkeSMuellerDet al.
Determinants of troponin release in patients with stable coronary artery disease: insights from CT angiography characteristics of atherosclerotic plaque. Heart2011;
97: 823–831.
14.
KvisvikBMørkridLRøsjøHet al.
High-sensitivity troponin T vs I in acute coronary syndrome: prediction of significant coronary lesions and long-term prognosis. Clin Chem2017;
63: 552–562.
15.
de LemosJADraznerMHOmlandTet al.
Association of troponin T detected with a highly sensitive assay and cardiac structure and mortality risk in the general population. JAMA2010;
304: 2503–2512.
16.
OmlandTPfefferMASolomonSDet al.
Prognostic value of cardiac troponin I measured with a highly sensitive assay in patients with stable coronary artery disease. J Am Coll Cardiol2013;
61: 1240–1249.
17.
GitsioudisGSchüsslerANagyEet al.
Combined assessment of high-sensitivity troponin T and noninvasive coronary plaque composition for the prediction of cardiac outcomes. Radiology2015;
276: 73–81.
18.
LauferEMMingelsAMWinkensMHet al.
The extent of coronary atherosclerosis is associated with increasing circulating levels of high sensitive cardiac troponin T. Arterioscler Thromb Vasc Biol2010;
30: 1269–1275.
19.
SittichanbunchaYSricharoenPTangkulpanichPet al.
The appropriate troponin T level associated with coronary occlusions in chronic kidney disease patients. Ther Clin Risk Manag2015;
11: 1143–1147.
20.
ParkHBLeeBKShinSet al.
Clinical feasibility of 3D automated coronary atherosclerotic plaque quantification algorithm on coronary computed tomography angiography: comparison with intravascular ultrasound. Eur Radiol2015;
25: 3073–3083.
21.
RodriguezKKwanACLaiSet al.
Coronary plaque burden at coronary CT angiography in asymptomatic men and women. Radiology2015;
277: 73–80.
22.
PapadopoulouSLNeefjesLAGarcia-GarciaHMet al.
Natural history of coronary atherosclerosis by multislice computed tomography. JACC Cardiovasc Imaging2012;
5: S28–S37.
23.
FerencikMMayrhoferTPuchnerSBet al.
Computed tomography-based high-risk coronary plaque score to predict acute coronary syndrome among patients with acute chest pain – results from the ROMICAT II trial. J Cardiovasc Comput Tomogr2015;
9: 538–545.
24.
AuscherSHeinsenLNiemanKet al.
Effects of intensive lipid-lowering therapy on coronary plaques composition in patients with acute myocardial infarction: assessment with serial coronary CT angiography. Atherosclerosis2015;
241: 579–587.
25.
CerqueiraMDWeissmanNJDilsizianVet al.
Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation2002;
105: 539–542.
26.
RousseeuwPJLeroyAM.Robust regression and outlier detection.
New York:
John Wiley & Sons, 1987.
27.
GoffDCJrLloyd-JonesDMBennettGet al.
2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol2014;
63: 2935–2959.
28.
LoJAbbaraSShturmanLet al.
Increased prevalence of subclinical coronary atherosclerosis detected by coronary computed tomography angiography in HIV-infected men. AIDS2010;
24: 243–253.
29.
D’AscenzoFCerratoECalcagnoAet al.
High prevalence at computed coronary tomography of non-calcified plaques in asymptomatic HIV patients treated with HAART: a meta-analysis. Atherosclerosis2015;
240: 197–204.
30.
BauerRWThiloCChiaramidaSAet al.
Noncalcified atherosclerotic plaque burden at coronary CT angiography: a better predictor of ischemia at stress myocardial perfusion imaging than calcium score and stenosis severity. AJR Am J Roentgenol2009;
193: 410–418.
31.
HultenEACarbonaroSPetrilloSPet al.
Prognostic value of cardiac computed tomography angiography: a systematic review and metaanalysis. J Am Coll Cardiol2011;
57: 1237–1247.
32.
PasterkampGFalkEWoutmanHet al.
Techniques characterizing the coronary atherosclerotic plaque: influence on clinical decision making?Am J Cardiol2000;
36: 13–21.
33.
PuriRNissenSELibbyPet al.
C-reactive protein, but not low-density lipoprotein cholesterol levels, associate with coronary atheroma regression and cardiovascular events after maximally intensive statin therapy. Circulation2013;
128: 2395–2403.
34.
ScottJ.Pathophysiology and biochemistry of cardiovascular disease. Curr Opin Genet Dev2004;
14: 271–279.
35.
BloomfieldGSLeungC.Cardiac disease associated with human immunodeficiency virus infection. Cardiol Clin2017;
35: 59–70.
36.
LaiHRedheuilATongWet al.
HIV infection and abnormal regional ventricular function. Int J Cardiovasc Imaging2009;
25: 809–817.
37.
HsuePYHuntPWHoJEet al.
Impact of HIV infection on diastolic function and left ventricular mass. Circ Heart Fail2010;
3: 132–139.
38.
OkekeNLAleneziFBloomfieldGSet al. Determinants of left ventricular hypertrophy and diastolic dysfunction in an HIV clinical cohort. J Card Fail. 2018 Jun 30. pii: S1071-9164(18)30227-6. doi: 10.1016/j.cardfail.2018.06.003. [Epub ahead of print].
39.
HollowayCJNtusiNSuttieJet al.
Comprehensive cardiac magnetic resonance imaging and spectroscopy reveal a high burden of myocardial disease in HIV patients. Circulation2013;
128: 814–822.
40.
SchusterCMayerFJWohlfahrtCet al.
Acute HIV infection results in subclinical inflammatory cardiomyopathy. J Infect Dis2018;
218: 466–470.
41.
LaiHStitzerMTreismanGet al.
Cocaine abstinence and reduced use associated with lowered marker of endothelial dysfunction in African Americans: a preliminary study. J Addict Med2015;
9: 331–339.
42.
SandfortVBluemkeDAVargasJet al.
Coronary plaque progression and regression in asymptomatic African American chronic cocaine users with obstructive coronary stenoses: a preliminary study. J Addict Med2017;
11: 126–137.
43.
ThygesenKMairJKatusHet al.
Recommendations for the use of cardiac troponin measurement in acute cardiac care. Eur Heart J2010;
31: 2197–2204.
44.
KatrukhaIA.Human cardiac troponin complex. Structure and functions. Biochemistry2013;
73: 1447–1465.
45.
WeiBJinJP.TNNT1, TNNT2, and TNNT3: isoform genes, regulation, and structure function relationships. Gene2016;
582: 1–13.
46.
WeiBJinJP.Troponin T isoforms and posttranscriptional modifications: evolution, regulation and function. Arch Biochem Biophys2011;
505: 144–154.
47.
PeyracchiaMDe LioGMontrucchioCet al.
Evaluation of coronary features of HIV patients presenting with ACS: the CUORE, a multicenter study. Atherosclerosis2018;
274: 218–226.
