TY - JOUR
T1 - Plasma plasminogen activator inhibitor-1 predicts myocardial infarction in HIV-1-infected individuals
AU - Knudsen, Andreas
AU - Katzenstein, Terese L
AU - Benfield, Thomas
AU - Jørgensen, Niklas R
AU - Kronborg, Gitte
AU - Gerstoft, Jan
AU - Obel, Niels
AU - Kjær, Andreas
AU - Lebech, Anne-Mette
PY - 2014
Y1 - 2014
N2 - OBJECTIVES: Biomarkers of endothelial dysfunction, inflammation and coagulation are associated with atherosclerosis and cardiovascular disease, but their association and possible predictive value remain controversial among HIV-1-infected individuals. We sought to investigate the association of seven biomarkers with first-time myocardial infarction (MI) in an HIV-1-infected population.DESIGN: A matched case-control study of 54 cases and 54 controls.METHODS: We compared 54 HIV-1-infected patients with verified first-time MI and 54 HIV-1-infected controls matched for age, duration of antiretroviral therapy, sex, smoking and no known cardiovascular disease. Levels of high-sensitivity C-reactive protein, soluble endothelial selectin, soluble vascular cell adhesion molecule, soluble intercellular adhesion molecule, matrix metalloprotease 9, myeloperoxidase, and plasminogen activator inhibitor 1 (PAI-1) were measured using a Luminex assay in plasma samples from routine visits both 12 and 2 months prior to the case patient's MI.RESULTS: The two groups had similar HIV characteristics and traditional cardiovascular risk factors. In univariate analysis, PAI-1 levels were associated with MI, whereas none of the other markers showed any association.In multivariate analyses adjusting for the D:A:D risk score, HIV viral load and high-sensitivity C-reactive protein, PAI-1 levels in the highest quartile were associated with a six to seven-fold increased risk of MI in both samples.CONCLUSION: High levels of PAI-1 were associated with risk of first-time MI in HIV-1-infected individuals independently of cardiovascular risk factors, HIV parameters and antiretroviral therapy. Therefore PAI-1 may be used for risk stratification and prediction of CHD, but further studies are needed.
AB - OBJECTIVES: Biomarkers of endothelial dysfunction, inflammation and coagulation are associated with atherosclerosis and cardiovascular disease, but their association and possible predictive value remain controversial among HIV-1-infected individuals. We sought to investigate the association of seven biomarkers with first-time myocardial infarction (MI) in an HIV-1-infected population.DESIGN: A matched case-control study of 54 cases and 54 controls.METHODS: We compared 54 HIV-1-infected patients with verified first-time MI and 54 HIV-1-infected controls matched for age, duration of antiretroviral therapy, sex, smoking and no known cardiovascular disease. Levels of high-sensitivity C-reactive protein, soluble endothelial selectin, soluble vascular cell adhesion molecule, soluble intercellular adhesion molecule, matrix metalloprotease 9, myeloperoxidase, and plasminogen activator inhibitor 1 (PAI-1) were measured using a Luminex assay in plasma samples from routine visits both 12 and 2 months prior to the case patient's MI.RESULTS: The two groups had similar HIV characteristics and traditional cardiovascular risk factors. In univariate analysis, PAI-1 levels were associated with MI, whereas none of the other markers showed any association.In multivariate analyses adjusting for the D:A:D risk score, HIV viral load and high-sensitivity C-reactive protein, PAI-1 levels in the highest quartile were associated with a six to seven-fold increased risk of MI in both samples.CONCLUSION: High levels of PAI-1 were associated with risk of first-time MI in HIV-1-infected individuals independently of cardiovascular risk factors, HIV parameters and antiretroviral therapy. Therefore PAI-1 may be used for risk stratification and prediction of CHD, but further studies are needed.
KW - Adult
KW - Biological Markers
KW - C-Reactive Protein
KW - Case-Control Studies
KW - Cell Adhesion Molecules
KW - Female
KW - HIV Infections
KW - HIV-1
KW - Humans
KW - Male
KW - Matrix Metalloproteinase 9
KW - Middle Aged
KW - Myocardial Infarction
KW - Peroxidase
KW - Plasminogen Activator Inhibitor 1
KW - Risk Factors
KW - Selectins
KW - Vascular Cell Adhesion Molecule-1
KW - Viral Load
U2 - 10.1097/qad.0000000000000247
DO - 10.1097/qad.0000000000000247
M3 - Journal article
C2 - 24566095
SN - 0269-9370
VL - 28
SP - 1171
EP - 1179
JO - AIDS
JF - AIDS
IS - 8
ER -
