Pitavastatin, Procollagen Pathways, and Plaque Stabilization in Patients With HIV

作者：Márton Kolossváry, Samuel R Schnittman, Markella V. Zanni, Kathleen V. Fitch, Carl J. Fichtenbaum, Judith A. Aberg, Gerald S. Bloomfield, Carlos Malvestutto, Judith S. Currier, Marissa R Diggs, Christopher R. deFilippi, Allison Ross Eckard, Adrián Curran, Murat Centinbas, Ruslan I. Sadreyev, Borek Foldyna, Thomas Mayrhofer, Júlia Karády, Jana Taron, Sara McCallum, Michael T. Lu, Heather J. Ribaudo, Pamela S. Douglas, Steven Grinspoon · 发表于：JAMA Cardiology · 年份：2024 · DOI：10.1001/jamacardio.2024.4115 · 被引用次数：14 · 研究领域：HIV-related health complications and treatments、Lipoproteins and Cardiovascular Health、Cardiovascular Disease and Adiposity

Importance: In a mechanistic substudy of the Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) randomized clinical trial, pitavastatin reduced noncalcified plaque (NCP) volume, but specific protein and gene pathways contributing to changes in coronary plaque remain unknown. Objective: To use targeted discovery proteomics and transcriptomics approaches to interrogate biological pathways beyond low-density lipoprotein cholesterol (LDL-C), relating statin outcomes to reduce NCP volume and promote plaque stabilization among people with HIV (PWH). Design, Setting, and Participants: This was a post hoc analysis of the double-blind, placebo-controlled, REPRIEVE randomized clinical trial. Participants underwent coronary computed tomography angiography (CTA), plasma protein analysis, and transcriptomic analysis at baseline and 2-year follow-up. The trial enrolled PWH from April 2015 to February 2018 at 31 US research sites. PWH without known cardiovascular diseases taking antiretroviral therapy and with low to moderate 10-year cardiovascular risk were eligible. Data analyses were conducted from October 2023 to February 2024. Intervention: Oral pitavastatin calcium, 4 mg per day. Main Outcomes and Measures: Relative change in plasma proteomics, transcriptomics, and noncalcified plaque volume among those receiving treatment vs placebo. Results: Among 558 individuals (mean [SD] age, 51 [6] years; 455 male [82%]) included in the proteomics assessment, 272 (48.7%) received pita...