冠状动脉CTA观察HIV感染者冠状动脉易损斑块

Observation on vulnerable coronary plaques in HIV-infected patients based on coronary CTA

目的观察HIV感染者冠状动脉易损斑块是否与非HIV感染者存在差异,分析相关危险因素。方法对167例HIV感染者(HIV感染组)及185例非感染者(非感染组)行冠状动脉CTA(CCTA),将存在≥2种高危形态学特征的斑块定义为易损斑块,对比分析2组患者冠状动脉易损斑块的类型、位置、发生率,以及HIV感染者冠状动脉易损斑块的相关危险因素。结果2组患者基线临床资料无明显差异。2组最常见易损斑块类型均为低衰减斑块+正性重构,多位于前降支近段(S6);HIV组≥1个冠状动脉节段出现易损斑块的发生率较非HIV组增加(34.73%vs 24.32%,P<0.05)。HIV组冠状动脉易损斑块与抗逆转录病毒治疗(ART)药物治疗时间独立相关[OR=1.29,95%CI(1.04,1.59),P=0.02]。结论HIV感染者冠状动脉易损斑块发生率较非感染者增加;ART药物治疗可能是HIV感染者出现冠状动脉易损斑块的独立危险因素。

Objective To explore whether vulnerable coronary plaques in HIV-infected patients are different with those in non-HIV-infected ones,and to analyze the relative risk factors.Methods A total of 167 HIV-infected patients(HIV-infected group)and 185 non-HIV-infected patients(non-HIV-infected group)who underwent coronary CTA(CCTA)were collected.Vulnerable plaques were defined as those with two or more high-risk morphological features.The type,location and incidence of vulnerable coronary plaques were analyzed and compared between 2 groups,and the risk factors of vulnerable coronary plaques in HIV-infected patients were analyzed.Results There was no significant difference of baseline clinical data between the two groups.The most common types of vulnerable coronary plaques in 2 groups were both low attenuation plaques+positive remodeling,most located in the proximal segment of left anterior descending artery(segment 6).The incidence of vulnerable coronary plaques≥1 coronary segments in HIV-infected patients was higher than that in non-HIV-infected patients(34.73%vs 24.32%,P<0.05).Vulnerable coronary plaques in HIV-infected patients were independently correlated with the duration of antiretroviral therapy(ART)drug(OR=1.29,95%CI[1.04,1.59],P=0.02).Conclusion The incidence of vulnerable coronary plaques in HIV-infected patients was higher than that in non-HIV-infected patients.ART drug may be an independent risk factor for coronary plaque vulnerability in HIV-infected patients.