TY - JOUR
T1 - Frailty and subclinical coronary atherosclerosis
T2 - The Multicenter AIDS Cohort Study (MACS)
AU - Korada, Sai Krishna C.
AU - Zhao, Di
AU - Tibuakuu, Martin
AU - Brown, Todd T.
AU - Jacobson, Lisa P.
AU - Guallar, Eliseo
AU - Bolan, Robert K.
AU - Palella, Frank J.
AU - Margolick, Joseph B.
AU - Martinson, Jeremy J.
AU - Budoff, Matthew J.
AU - Post, Wendy S.
AU - Michos, Erin D.
N1 - Funding Information:
This study is funded by the National Heart, Lung and Blood Institute (grant R01 HL095129 to Dr. Post). The MACS is funded by the National Institute of Allergy and Infectious Diseases (NIAID) , with additional supplemental funding from the National Cancer Institute (NCI) , the National Institute on Drug Abuse (NIDA) , the National Institute of Mental Health (NIMH) , and the National Heart, Lung, and Blood Institute as follows: UO1-AI-35042 , UL1-RR025005 , UM1-AI-35043 , UO1-AI-35039 , UO1-AI-35040 , UO1-AI-35041 . Mr. Korada was supported for this work by the American Federation for Aging Research Medical Student Training in Aging Research (NIA – MSTAR) program grant 2T35AG26758-11 . Drs. Michos and Zhao are supported by the Blumenthal Scholars Program in Preventive Cardiology . Dr. Brown is supported in part by the National Institute of Allergy and Infectious Diseases ( K24 AI120834 ).
Funding Information:
This work was funded by grants from the NIH , but the funding source had no input in writing or design of manuscript.
Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2017/11
Y1 - 2017/11
N2 - Background and aims Frailty and cardiovascular disease share many risk factors. We evaluated whether frailty is independently associated with subclinical coronary atherosclerosis and whether any relationships differ by HIV-serostatus. Methods We studied 976 [62% HIV-infected] male participants of the Multicenter AIDS Cohort Study who underwent assessment of frailty and non-contrast cardiac CT scanning; of these, 747 men also underwent coronary CT angiography (CCTA). Frailty was defined as having ≥3 of 5 of the following: weakness, slowness, weight loss, exhaustion, and low physical activity. Coronary artery calcium (CAC) was assessed by non-contrast CT, and total plaque score (TPS), mixed plaque score (MPS), and non-calcified plaque score (NCPS) by CCTA. Multivariable-adjusted regression was used to assess the cross-sectional associations between frailty and subclinical coronary atherosclerosis. Results Mean (SD) age of participants was 54 (7) years; 31% were black. Frailty existed in 7.5% and 14.3% of HIV-uninfected and HIV-infected men, respectively. After adjustment for demographics, frailty was significantly associated with prevalence of any CAC (CAC>0), any plaque (TPS>0), and mixed plaque (MPS>0) in HIV-uninfected but not in HIV-infected men (p-interactionHIV<0.05 for all). Among HIV-uninfected men, after adjustment for cardiovascular risk factors, frailty was significantly associated only with CAC>0 [Prevalence Ratio 1.27 (95%CI 1.02, 1.59)] and TPS>0 [1.19 (1.06, 1.35)]. No association was found for NCPS. Conclusions Frailty was independently associated with subclinical coronary atherosclerosis among HIV-uninfected men, but not among HIV-infected men. Further work is needed to ascertain mechanisms underlying these differences and whether interventions that improve frailty (i.e. strength training) can improve cardiovascular outcomes.
AB - Background and aims Frailty and cardiovascular disease share many risk factors. We evaluated whether frailty is independently associated with subclinical coronary atherosclerosis and whether any relationships differ by HIV-serostatus. Methods We studied 976 [62% HIV-infected] male participants of the Multicenter AIDS Cohort Study who underwent assessment of frailty and non-contrast cardiac CT scanning; of these, 747 men also underwent coronary CT angiography (CCTA). Frailty was defined as having ≥3 of 5 of the following: weakness, slowness, weight loss, exhaustion, and low physical activity. Coronary artery calcium (CAC) was assessed by non-contrast CT, and total plaque score (TPS), mixed plaque score (MPS), and non-calcified plaque score (NCPS) by CCTA. Multivariable-adjusted regression was used to assess the cross-sectional associations between frailty and subclinical coronary atherosclerosis. Results Mean (SD) age of participants was 54 (7) years; 31% were black. Frailty existed in 7.5% and 14.3% of HIV-uninfected and HIV-infected men, respectively. After adjustment for demographics, frailty was significantly associated with prevalence of any CAC (CAC>0), any plaque (TPS>0), and mixed plaque (MPS>0) in HIV-uninfected but not in HIV-infected men (p-interactionHIV<0.05 for all). Among HIV-uninfected men, after adjustment for cardiovascular risk factors, frailty was significantly associated only with CAC>0 [Prevalence Ratio 1.27 (95%CI 1.02, 1.59)] and TPS>0 [1.19 (1.06, 1.35)]. No association was found for NCPS. Conclusions Frailty was independently associated with subclinical coronary atherosclerosis among HIV-uninfected men, but not among HIV-infected men. Further work is needed to ascertain mechanisms underlying these differences and whether interventions that improve frailty (i.e. strength training) can improve cardiovascular outcomes.
KW - Cardiac CT
KW - Coronary artery calcium
KW - Coronary atherosclerosis
KW - Frailty
KW - HIV-Infection
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U2 - 10.1016/j.atherosclerosis.2017.08.026
DO - 10.1016/j.atherosclerosis.2017.08.026
M3 - Article
C2 - 28886899
AN - SCOPUS:85028728724
VL - 266
SP - 240
EP - 247
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
ER -
