Abstract 14577: Racial Differences in Plaque Composition Among HIV Seropositive and Seronegative Men in the Multicenter Aids Cohort Study (MACS)
Background: Previous studies show that blacks have less coronary artery calcification (CAC) than whites. We evaluated plaque composition and stenosis using coronary CT angiography (CCTA) to evaluate racial differences in the MACS.
Methods: HIV seropositive (SP) and seronegative (SN) men who have sex with men (MSM) in the MACS were recruited for non-contrast cardiac CT and CCTA if they were 40-70 years, weighed <300 pounds, and had no prior history of cardiac surgery or revascularization. There were 873 men who underwent non-contrast CT scans and 660 men had CCTA (32% black). We measured CAC from non-contrast CT scans and TPS (total plaque score), NCPS (non-calcified), CPS (calcified), and MPS (mixed plaque score), and stenosis greater than 50% from CCTA. Logistic regression was used to assess associations between plaque presence (score > 0) and self reported race. Log linear regression was used to assess the association between extent of plaque in men with plaque present. Models were adjusted for age, CAD risk factors and education as a proxy for socioeconomic status.
Results: Black men had lower prevalences of CAC (OR=0.67, p=0.04), CP (OR=0.51, p=0.005), and stenosis greater than 50% (OR=0.46, p=0.02) than white men. HIV did not modify these associations. There was a significant HIV interaction between race and presence of MP (p=0.01). Black men had a lower prevalence of MP (OR=0.56, p=0.04) than whites in SP, but not SN men (OR=1.7, p=0.21). In contrast to these racial differences for prevalence, among men with plaque present, the extent of CAC, CP or MP did not vary by race (all p > 0.20). There were no associations between race and the prevalence of any plaque (TPS>0) (OR=0.92, p=0.74) or NCP (OR=1.17, p=0.48) on CCTA; however, there was a significant HIV interaction between race and extent of plaque (TPS) (p=0.005) and a borderline (p=0.08) interaction for NCP. The TPS and NCPS were both lower in black than white men in SP (p=0.004, p=0.03 respectively), but not in SN men (both p>0.20).
Conclusion: Racial differences exist in calcified and non-calcified coronary plaque when comparing black and white men. In general, less plaque and stenosis exist in black men, especially HIV SP men. The etiology and dynamic nature of these differences requires further study.
- © 2013 by American Heart Association, Inc.