Advertisement

 

 

Rosuvastatin slows progression of subclinical atherosclerosis in patients with treated HIV infection.

Author Information (click to view)

Longenecker CT, Sattar A, Gilkeson R, Mccomsey GA,


Longenecker CT, Sattar A, Gilkeson R, Mccomsey GA, (click to view)

Longenecker CT, Sattar A, Gilkeson R, Mccomsey GA,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

AIDS (London, England) 2016 5 19()

Abstract
OBJECTIVE
To determine the effect of statins on the progression of subclinical atherosclerosis in a population of HIV-infected adults on antiretroviral therapy.

DESIGN
Double-blind, randomized clinical trial METHODS:: SATURN-HIV was a 96-week double-blind, randomized clinical trial of 10 mg daily rosuvastatin (n = 72) versus placebo (n = 75) in a population of HIV-infected subjects on stable antiretroviral therapy with LDL-cholesterol ≤130 mg/dL (≤3.36mmol/L) and evidence of heightened T-cell activation (CD8+CD38+HLA-DR+ ≥19%) or increased inflammation (high sensitivity C-reactive protein ≥2 mg/L (≥19mmol/L)). Change in common carotid artery IMT (CCA-IMT) was the primary outcome. Secondary outcomes were changes in LDL and coronary artery calcium (CAC).

RESULTS
Median (Q1, Q3) age was 46 (40, 53) years; 78% were male and 68% African American; 49% were on a protease inhibitor. Mean (95% CI) change in LDL was -21 (-27 to -15) mg/dL [-0.54 (-0.70 to -0.39) mmol/L] in the rosuvastatin arm. In a multivariable linear mixed-effects model, assignment to statin was associated with 0.019 mm (95% CI: 0.002-0.037 mm) less progression of CCA-IMT over 96 weeks. We did not find substantial effect modification by level of inflammation or immune activation biomarkers, except for a borderline statistically significant interaction for soluble vascular cell adhesion molecule (p = 0.065). There was no difference in CAC change (p = 0.61).

CONCLUSIONS
Rosuvastatin effectively lowers LDL and appears to substantially slow progression of CCA-IMT in patients with treated HIV infection. Future study is needed to determine whether subjects with higher levels of inflammation or immune activation derive greater cardiovascular benefit from statin therapy.

Submit a Comment

Your email address will not be published. Required fields are marked *

two × 1 =

[ HIDE/SHOW ]