Coronary Plaque, Inflammation, Subclinical Myocardial Injury, and Major Adverse Cardiovascular Events in the REPRIEVE Substudy

作者：Michael T. Lu, Heather J. Ribaudo, Sara McCallum, Markella V. Zanni, Christopher R. deFilippi, Jana Taron, Júlia Karády, Borek Foldyna, Kayla Paradis, Sarah M Chu, Marissa R Diggs, Tricia H. Burdo, Judith S. Currier, Gerald S. Bloomfield, Carl J. Fichtenbaum, Carlos Malvestutto, Judith A. Aberg, Thomas Mayrhofer, Pamela S. Douglas, Steven Grinspoon · 发表于：JACC Advances · 年份：2025 · DOI：10.1016/j.jacadv.2025.101781 · 被引用次数：8 · 研究领域：HIV-related health complications and treatments、Lipoproteins and Cardiovascular Health、Cardiac Imaging and Diagnostics

BACKGROUND: In REPRIEVE (Randomized Trial to Prevent Vascular Events in HIV), pitavastatin prevented major adverse cardiovascular events (MACE) and reduced noncalcified coronary plaque (NCP) among people with HIV and low-to-moderate traditional cardiovascular disease (CVD) risk. OBJECTIVES: The purpose of this study was to assess the relationship of coronary plaque, inflammation, and subclinical myocardial injury with MACE. METHODS: A total of 804 REPRIEVE Mechanistic Substudy participants enrolled from April 2015 to February 2018 at 31 U.S. sites, randomized to pitavastatin 4 mg/day or placebo, and followed for incident MACE (median 6.2 years [Q1-Q3 5.4-7.1]), were assessed for relationships of baseline NCP, markers of inflammation (high-sensitivity C-reactive protein [hs-CRP], interleukin (IL)-6, oxidized low-density lipoprotein, and lipoproprotein-associated phospholipase A2), and subclinical myocardial injury (high-sensitivity cardiac troponin T [hs-cTnT]) with MACE. RESULTS: Among enrolled participants (17% female [139/804], 47% non-White [379/804], median age 51 years, median low-density lipoprotein 105 mg/dL, 10-year atherosclerotic CVD [ASCVD] risk 4.6%, 40% [299/755] with noncalcified plaque), MACE incidence was 7.26/1,000 (95% CI: 4.51-11.7) person-years (17 events) for pitavastatin and 9.15/1,000 person-years (95% CI: 5.97-14.0) (21 events) for placebo. The hazard of MACE was greater in those with (vs without) noncalcified plaque (HR: 2.5; [95% CI: 1.3-4.8]; P = 0....