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Statins reduced non-calcified coronary plaque in HIV patients

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SEATTLE — Statin therapy may reduce the volume of non-calcified coronary plaque in patients with HIV and subclinical atherosclerosis, according to data presented here at CROI 2015.

“Numerous epidemiological studies have shown that coronary artery disease is a major cause of morbidity and mortality for patients living with HIV around the world today,” Janet Lo, MD, of the Massachusetts General Hospital and Harvard Medical School, said during an oral presentation. “Within the HIV population, statins have been demonstrated to improve lipids, endothelial function on markers of inflammation, and immune activation, as well as other effects. However, no studies have yet directly assessed the effects of statins on coronary plaque in HIV patients.”

Lo and colleagues examined the effect of statins on non-calcified plaque and high-risk plaque features such as low attenuation, spotty calcification and positive remodeling index in 40 patients with HIV These participants, who were also diagnosed with subclinical atherosclerosis and had LDL cholesterol under 130mg/dL, were randomized to 1 year of atorvastatin or placebo. Plaque volume was measured by coronary computed tomography angiography.

The researchers found a 19.4% reduction in non-calcified coronary plaque volume in patients receiving atorvastatin, as opposed to an increase of 20.4% in the placebo group (P=.009). Significant reductions were also seen in the number of high-risk plaques, direct LDL cholesterol and lipoprotein-associated phospholipase A2. There was a low incidence of clinical adverse events.

“Statin therapy not only prevented the progression of coronary atherosclerosis, but it reduced overall plaque volume,” Lo said. “Future studies are needed to address whether statins or other anti-inflammatory agents can reduce arterial inflammation in HIV patients.”

– by Dave Muoio

Reference: Lo J, et al. Abstract #136. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 23-26, 2015; Seattle.

Disclosure: Lo reports no relevant financial disclosures.