TY - JOUR
T1 - Determinants of developing widened spatial QRS-T angle in HIV-infected individuals
T2 - Results from the Strategies for Management of Antiretroviral Therapy [SMART] Study
AU - Dawood, Farah
AU - Roediger, Mollie P.
AU - Grandits, Greg
AU - Miller, Dery
AU - Fisher, Martin
AU - Zhang, Zhu-Ming
AU - Hodder, Sally
AU - Hoy, Jennifer
AU - Lundgren, Jens D
AU - Neaton, James D.
AU - Soliman, Elsayed Z
AU - INSIGHT SMART Study Group
AU - Ostergaard, L.
AU - Pedersen, C.
AU - Nielsen, H.
AU - Hergens, L.
AU - Loftheim, I.R.
AU - Jensen, K. B.
AU - Raukas, M.
AU - Zilmer, K.
AU - Justinen, J.
AU - Ristola, M.
AU - Girard, P. M.
AU - Landman, S.
AU - Abel, S.
AU - Abgrall, S.
AU - Amat, K.
AU - Auperin, L.
AU - Barruet, R.
AU - Benalycherif, A.
AU - Benammar, N.
AU - Bensalem, M.
AU - Bentata, M.
AU - Besnier, J. M.
AU - Blanc, M.
AU - Bouchaud, O.
AU - Cabie, A.
AU - Chavannet, P.
AU - Chennebault, J. M.
AU - Dargere, S.
AU - de la Tribonniere, X.
AU - Debord, T.
AU - Delgado, J.
AU - Decaux, N.
AU - Dupon, M.
AU - Durant, J.
AU - Frixon-Marin, V.
AU - Genet, C.
AU - Gerard, L.
AU - Gilquin, J.
AU - Hoen, B.
PY - 2014
Y1 - 2014
N2 - BACKGROUND: Higher plasma D-dimer levels are strong predictors of mortality in HIV+ individuals. The factors associated with D-dimer levels during HIV infection, however, remain poorly understood.METHODS: In this cross-sectional study, participants in three randomized controlled trials with measured D-dimer levels were included (N = 9,848). Factors associated with D-dimer were identified by linear regression. Covariates investigated were: age, gender, race, body mass index, nadir and baseline CD4+ count, plasma HIV RNA levels, markers of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6]), antiretroviral therapy (ART) use, ART regimens, co-morbidities (hepatitis B/C, diabetes mellitus, prior cardiovascular disease), smoking, renal function (estimated glomerular filtration rate [eGFR] and cystatin C) and cholesterol.RESULTS: Women from all age groups had higher D-dimer levels than men, though a steeper increase of D-dimer with age occurred in men. Hepatitis B/C co-infection was the only co-morbidity associated with higher D-dimer levels. In this subgroup, the degree of hepatic fibrosis, as demonstrated by higher hyaluronic acid levels, but not viral load of hepatitis viruses, was positively correlated with D-dimer. Other factors independently associated with higher D-dimer levels were black race, higher plasma HIV RNA levels, being off ART at baseline, and increased levels of CRP, IL-6 and cystatin C. In contrast, higher baseline CD4+ counts and higher high-density lipoprotein cholesterol were negatively correlated with D-dimer levels.CONCLUSIONS: D-dimer levels increase with age in HIV+ men, but are already elevated in women at an early age due to reasons other than a higher burden of concomitant diseases. In hepatitis B/C co-infected individuals, hepatic fibrosis, but not hepatitis viral load, was associated with higher D-dimer levels.
AB - BACKGROUND: Higher plasma D-dimer levels are strong predictors of mortality in HIV+ individuals. The factors associated with D-dimer levels during HIV infection, however, remain poorly understood.METHODS: In this cross-sectional study, participants in three randomized controlled trials with measured D-dimer levels were included (N = 9,848). Factors associated with D-dimer were identified by linear regression. Covariates investigated were: age, gender, race, body mass index, nadir and baseline CD4+ count, plasma HIV RNA levels, markers of inflammation (C-reactive protein [CRP], interleukin-6 [IL-6]), antiretroviral therapy (ART) use, ART regimens, co-morbidities (hepatitis B/C, diabetes mellitus, prior cardiovascular disease), smoking, renal function (estimated glomerular filtration rate [eGFR] and cystatin C) and cholesterol.RESULTS: Women from all age groups had higher D-dimer levels than men, though a steeper increase of D-dimer with age occurred in men. Hepatitis B/C co-infection was the only co-morbidity associated with higher D-dimer levels. In this subgroup, the degree of hepatic fibrosis, as demonstrated by higher hyaluronic acid levels, but not viral load of hepatitis viruses, was positively correlated with D-dimer. Other factors independently associated with higher D-dimer levels were black race, higher plasma HIV RNA levels, being off ART at baseline, and increased levels of CRP, IL-6 and cystatin C. In contrast, higher baseline CD4+ counts and higher high-density lipoprotein cholesterol were negatively correlated with D-dimer levels.CONCLUSIONS: D-dimer levels increase with age in HIV+ men, but are already elevated in women at an early age due to reasons other than a higher burden of concomitant diseases. In hepatitis B/C co-infected individuals, hepatic fibrosis, but not hepatitis viral load, was associated with higher D-dimer levels.
U2 - 10.1016/j.jelectrocard.2013.12.001
DO - 10.1016/j.jelectrocard.2013.12.001
M3 - Journal article
SN - 0022-0736
VL - 47
SP - 264
EP - 271
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
IS - 2
ER -