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Patients with HIV prone to coronary endothelial dysfunction
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Adults treated for HIV had elevated serum PCSK9 levels and abnormal coronary endothelial function, researchers reported.
The researchers compared 48 patients with HIV (mean age, 52 years; 81% men) who were receiving antiretroviral therapy and had suppressed viral replication and no CAD with 15 healthy controls (mean age, 49 years; 47% men) matched for age and LDL level.
All participants underwent MRI to measure coronary endothelial function and blood tests for serum PCSK9 and systemic vascular biomarkers.
Compared with controls, mean serum PCSK9 was 65% higher in the HIV group (302 ng/mL vs. 183 ng/mL; P < .0001), Thorsten M. Leucker, MD, PhD, from the division of cardiology at Johns Hopkins School of Medicine, and colleagues wrote.
Coronary endothelial function was reduced in the HIV group vs. controls (percentage change in coronary artery cross-sectional area, 2.9% vs. 11.1%; P < .0001), and coronary endothelial function was inversely related to serum PCSK9 level (R = –0.51; P < .0001), according to the researchers.
Leucker and colleagues also found that in the HIV group, P-selectin and thrombomodulin were elevated vs. controls, and P-selectin was correlated with serum PCSK9 (R = 0.31; P = .0144).
“This study demonstrates that serum PCSK9 levels are significantly higher in treated HIV+ individuals than in HIV– subjects and confirms our prior findings that [coronary endothelial function] is significantly impaired in HIV+ people, despite adequate CD4+ counts, undetectable viral loads, and LDL-C levels equivalent to those of an HIV– age-matched control group,” Leucker and colleagues wrote. “Cardiovascular event rates remain high in HIV+ patients taking statins and after adjusting for traditional risk factors, including LDL-C, suggesting a role for targeting nontraditional risk factors in this population. The results of our study indicate that one such nontraditional risk factor may be elevated serum PCSK9.” – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.
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