RESEARCH PAPER
High platelet count and high low-density lipoprotein level may be an independent marker of increased arterial stiffness
in adult HIV-infected persons
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1
Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland
2
Chair and Department of Cardiology, Medical University of Warsaw, Poland
Submission date: 2019-02-26
Acceptance date: 2019-03-07
Publication date: 2019-03-15
HIV & AIDS Review 2019;18(1):14-18
KEYWORDS
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ABSTRACT
Introduction:
Cardiovascular disease is an increasing and leading cause of morbidity and mortality in people living with human immunodeficiency virus (PLHIV) infection. Arterial stiffness is a predictor of endothelial dysfunction in subclinical patients. The aim of this study was to assess which of the laboratory parameters performed during the standard PLHIV medical care visit may be associated with increased arterial stiffness.
Material and methods:
Thirty HIV-1-infected adult patients (four females and 26 males) were recruited to this study. Endothelial dysfunction and arterial stiffness assessment was performed using the Endo-PAT 2000 device (ITAMAR®). Baseline pressure waveform obtained by peripheral arterial tonometry (PAT) was used to calculate the augmentation index (AI). AI values were corrected for heart rate using an arbitrarily defined reference heart rate of 75 bpm (AI@75).
Results:
Our analysis included 30 patients. Men comprised 87% (n = 26), 16 patients (53%) were on combined antiretroviral therapy (cART), 11 patients (36.7%) had undetectable HIV viral load, 15 patients (50%) had active or previous hepatitis C virus (HCV) or hepatitis B virus (HBV) co-infection, and 16 patients (53%) smoked cigarettes. In univariate analysis, only total platelet count and effective cART use influenced arterial stiffness in PLHIV. In multivariate analysis, the variables with confirmed statistical significance were low-density lipoprotein (LDL) (p = 0.040; slope estimate = 6.30 per mmol/l of LDL) and platelet (PLT) count (p = 0.003; slope estimate = 0.13 per 109/l of platelet count).
Conclusions:
We showed that high LDL concentration and high total platelet count may be an independent risk factor of the subclinical atherosclerotic disease in PLHIV. Moreover, we observed a possible negative influence of cART on arterial stiffness.
REFERENCES (24)
1.
Palella FJ Jr, Baker RK, Moorman AC, et al. Mortality in the highly active antiretroviral therapy era: changing causes of death and disease in the HIV outpatient study. J Acquir Immune Defic Syndr 2006; 43: 27-34.
2.
Wang T, Green LA, Gupta SK, et al. Transfer of intracellular HIV Nef to endothelium causes endothelial dysfunction. PLoS One 2014; 9: e91063.
3.
Jiang J, Fu W, Wang X, et al. HIV gp120 induces endothelial dysfunction in tumour necrosis factor‐α‐activated porcine and human endothelial cells. Cardiovasc Res 2010; 87: 366-374.
4.
Gowdaiah P, Reddy S, Joseph J. Clinical study of lipid abnormalities in anti-retroviral treatment-naive HIV patients. Int J Adv Med 2015; 2: 365-369.
5.
Knobel H, Domingo P, Suarez-Lozano I, et al. Rate of cardiovascular, renal and bone disease and their major risks factors in HIV-infected individuals on antiretroviral therapy in Spain. Enferm Infecc Microbiol Clin 2018; doi: 10.1016/j.eimc.2018.09.015 [Epub ahead of print].
6.
Alvi RM, Neilan AM, Tariq N, et al. Protease Inhibitors and Cardiovascular Outcomes in Patients With HIV and Heart Failure. J Am Coll Cardiol 2018; 72: 518-530.
7.
Ross R. The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature 1993; 362: 801-809.
8.
Leite LH, Cohen A, Boccara F. HIV infection and aortic stiffness. Arch Cardiovasc Dis 2017; 110: 495-502.
9.
Bonetti PO, Pumper GM, Higano ST, et al. Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia. J Am Coll Cardiol 2004; 44: 2137-2141.
10.
Yannoutsos A, Ghosn J, Blacher J. Arterial hemodynamic parameters and cardiovascular risk in HIV patients with controlled infection. Presse Med 2018; 47: 3-10.
11.
Balsam P, Mikuła T, Peller M, et al. Evaluation of endothelial function and arterial stiffness in HIV-infected patients: a pilot study. Kardiol Pol 2015; 73: 344-351.
12.
Mikuła T, Balsam P, Peller M, et al. The effects of CD4 nadirs on vessel stiffness in HIV patients undergoing antiretroviral therapy. Kardiol Pol 2017; 75: 749-757.
13.
Bonetti PO, Pumper GM, Higano ST. Research highlights – editorial review of a noninvasive test for endothelial dysfunction. Nature Clin Practice Cardiovasc Med 2005; 2: 64-65.
14.
Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cuse mortality with arterial stiffness: a systematic review and meta-analysis. J Am Coll Cardiol 2010; 55: 1318-1327.
15.
Sloan A, Gona P, Johnson AD. Cardiovascular correlates of platelet count and volume in the Framingham Heart Study. Ann Epidemiol 2015; 25: 492-498.
16.
Monteiro Júnior JGM, Torres DOC, da Silva MCFC, et al. Prognostic value of hematological parameters in patients with acute myocardial infarction: Intrahospital outcomes. PLoS One 2018; 13: e0194897.
17.
Tian C, Song J, He D, et al. Predictive value of mean platelet volume/platelet count for prognosis in acute myocardial infarction. Int Heart J 2018; 59: 286-292.
18.
Noris P, Melazzini F, Balduini CL. New roles for mean platelet volume measurement in the clinical practice? Platelets 2016; 27: 607-612.
19.
Choi DH, Kang SH, Song H. Mean platelet volume: a potential biomarker of the risk and prognosis of heart disease. Korean J Intern Med 2016; 31: 1009-1017.
20.
Vinholt PJ, Hvas AM, Frederiksen H, et al. Platelet count is associated with cardiovascular disease, cancer and mortality: a population-based cohort study. Thromb Res 2016; 148: 136-142.
21.
Lawler PR, Akinkuolie AO, Chu AY, et al. Atherogenic lipoprotein determinants of cardiovascular disease and residual risk among individuals with low low-density lipoprotein cholesterol. J Am Heart Assoc 2017; 6: e005549.
22.
Maggi P, Di Biagio A, Rusconi S, et al. Cardiovascular risk and dyslipidemia among persons living with HIV: a review. BMC Infect Dis 2017; 17: 551.
24.
Schillaci G, De Socio GV, Pirro M, et al. Impact of treatment with protease inhibitors on aortic stiffness in adult patients with human immunodeficiency virus infection. Arterioscler Thromb Vasc Biol 2005; 25: 2381-2385.