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

Research output: Contribution to journalJournal articleResearchpeer-review

Andreas Knudsen, Terese L Katzenstein, Thomas Benfield, Niklas R Jørgensen, Gitte Kronborg, Jan Gerstoft, Niels Obel, Andreas Kjær, Anne-Mette Lebech

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.

Original languageEnglish
JournalAIDS
Volume28
Issue number8
Pages (from-to)1171-1179
Number of pages9
ISSN0269-9370
DOIs
Publication statusPublished - 2014

    Research areas

  • Adult, Biological Markers, C-Reactive Protein, Case-Control Studies, Cell Adhesion Molecules, Female, HIV Infections, HIV-1, Humans, Male, Matrix Metalloproteinase 9, Middle Aged, Myocardial Infarction, Peroxidase, Plasminogen Activator Inhibitor 1, Risk Factors, Selectins, Vascular Cell Adhesion Molecule-1, Viral Load

ID: 137618902