Plasma plasminogen activator inhibitor-1 predicts myocardial infarction in HIV-1-infected individuals

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 - 1350-2840

VL - 28

SP - 1171

EP - 1179

JO - AIDS, Supplement

JF - AIDS, Supplement

IS - 8

ER -