Associations between Tobacco, Alcohol, and Drug Use with Coronary Artery Plaque among HIV-Infected and Uninfected Men in the Multicenter AIDS Cohort Study

Background

We characterized associations between smoking, alcohol, and recreational drug use and coronary plaque by HIV serostatus within the Multicenter AIDS Cohort Study (MACS).

Methods

MACS participants (N = 1005, 621 HIV+ and 384 HIV-) underwent non-contrast CT scanning to measure coronary artery calcium; 764 underwent coronary CT angiograms to evaluate plaque type and extent. Self-reported use of alcohol, tobacco, smoked/inhaled cocaine, methamphetamine, ecstasy, marijuana, inhaled nitrites, and erectile dysfunction drugs was obtained at semi-annual visits beginning 10 years prior to CT scanning. Multivariable logistic and linear regression models were performed, stratified by HIV serostatus.

Results

Among HIV+ men, current smoking, former smoking, and cumulative pack years of smoking were positively associated with multiple coronary plaque measures (coronary artery calcium presence and extent, total plaque presence and extent, calcified plaque presence, and stenosis >50%). Smoking was significantly associated with fewer plaque measures of comparable effect size among HIV- men; current smoking and calcified plaque extent was the only such association. Heavy alcohol use (>14 drinks/week) was associated with stenosis >50% among HIV+ men. Among HIV- men, low/moderate (1–14 drinks/week) and heavy alcohol use were inversely associated with coronary artery calcium and calcified plaque extent. Few significant associations between other recreational drug use and plaque measures were observed.

Conclusion

Smoking is strongly associated with coronary plaque among HIV+ men, underscoring the value of smoking cessation for HIV+ persons. Alcohol use may protect against coronary artery calcium and calcified plaque progression in HIV- (but not HIV+) men. Few positive associations were observed between recreational drug use and coronary plaque measures.

Full article at:   http://goo.gl/CBcHii

By:  

Sean G. Kelly, Frank J. Palella Jr.

Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America

Michael Plankey

Georgetown University, Washington, D. C., United States of America

Wendy S. Post

Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America

Wendy S. Post, Xiuhong Li, Lisa P. Jacobson, Christopher Cox

Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America

Ronald Stall, Lawrence Kingsley

University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, United States of America

Mallory D. Witt, Matthew Budoff

Harbor-UCLA Medical Center, Torrance, California‎, United States of America

  

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