Abstract 17855: Association of Echolucency of the Carotid Artery Wall with Coronary Artery Plaque Composition in HIV- infected and -uninfected men: a Multicenter AIDS Cohort Study (MACS) Substudy
Background: Carotid artery echolucency may represent the deposition of lipids and is an independent predictor of coronary artery disease (CAD) events. The association of carotid echolucency with HIV and correlation with coronary artery plaque as assessed by coronary CT angiography (CCTA) is unclear.
Methods: HIV-infected and -uninfected MACS participants who were 40-70 years of age with no history of cardiac intervention underwent non-contrast CT and CCTA for assessment of coronary artery atherosclerosis and high-resolution B-mode ultrasonography for assessment of carotid arterial wall echodensity determined as grey-scale median (GSM) of the far wall of the right common carotid artery. Associations between GSM and HIV serostatus, the presence of coronary artery calcium (CAC), non-calcified coronary artery plaque and coronary artery stenosis > 50% were assessed with linear regression adjusting for age and race and then for CAD risk factors.
Results: Mean GSM among 324 HIV-infected and 142 uninfected men was 72.6 and 74.9, respectively (p=0.20). GSM was inversely associated with age and body mass index (both p<0.001). There was a trend towards lower GSM (greater echolucency) in HIV-infected men compared to HIV uninfected men after adjusting for CAD risk factors (estimate -3.0, p=0.08). Men with CAC tended to have a higher GSM after adjustment for HIV serostatus and CAD risk factors, (estimate 2.7, p= 0.095). Men with non-calcified coronary artery plaque tended to have lower GSM (estimate -3.4, p=0.075), which was no longer present after adjusting for CAD risk factors (p=0.50). There was no association between coronary artery stenosis > 50% and GSM.
Conclusion: HIV-infected men tended to have greater echolucency in the far wall of the common carotid artery than HIV-uninfected men, which may represent more unstable, lipid-rich plaque. Echolucency tended to be associated with the presence of non-calcified plaque in the coronary arteries and was inversely associated with CAC. Additional studies are needed to assess the risk of cardiovascular disease events associated with carotid echolucency as a potential novel marker of cardiovascular disease risk in people with HIV.
Author Disclosures: P. Miller: None. H.N. Hodis: None. X. Li: None. A.R. Sharrett: None. L.A. Kingsley: None. F.J. Palella: Speakers Bureau; Modest; Gilead Sciences, Janssen Pharmaceuticals, Merck & Co., Inc., Bristol-Myers Squibb. M.D. Witt: None. R. Kaplan: None. L.P. Jacobson: Consultant/Advisory Board; Modest; Bristol-Myers Squibb. M. Budoff: None. W.S. Post: None.
- © 2014 by American Heart Association, Inc.