Article Text
Abstract
Introduction Platelets play a key role in coronary artery disease (CAD). Glycoprotein VI (GPVI) is a platelet specific collagen receptor which is shed when activated. Soluble (s) GPVI is associated with CAD in the general population and lower levels have been found in patients taking abacavir. This trial was performed to determine if sGPVI was predictive of CAD in HIV.
Methods 24 HIV+ subjects with CAD (HIV+ cases) with stored plasma available in the 12 months before CAD diagnosis were age and sex matched 1:2 with 46 HIV+ subjects without CAD (HIV+ controls). 41 HIV negative controls (healthy controls) were used as comparators. HIV+ patients had two samples analysed; 12 and 1 month before CAD diagnosis; healthy controls had a single sample analysed (202 samples in total). sGPVI was determined by ELISA.
Results Of the combined HIV+ subjects 63 [90%] were male; mean 51 years; 92.8% taking antiretrovirals. HIV+ subjects (combined HIV+ cases and HIV+ controls) were more likely to smoke (34 [30.6%] v’s 3 [7.3%], p < 0.001) than healthy controls. HIV+ cases were hypertensive (13 [54.1%] v’s 5 [10.8%], p < 0.001) and had a family history of CAD (12 [52.1%] v’s 9 [25.0%], p 0.033) at higher rates than HIV+ controls. sGPVI was higher in HIV+ subjects (combined) then healthy controls (129.9 ng/ml [SD 59.5] v’s 84.4 ng/ml [SD 46.1], p < 0.001). 12 months before event there was no difference in sGPVI between HIV+ cases and HIV+ controls (123.2 ng/ml [SD 61.7] v’s 137.8 ng/ml [SD 63.5], p 0.369). 1 month before event sGPVI was significantly lower in HIV+ cases (111.1 ng/ml [SD 45.0] v’s 143.9 ng/ml [SD 56.1], p 0.016).
Conclusion HIV+ subjects have higher sGPVI than healthy controls; sGPVI is lower prior to CAD event in HIV+. sGPVI may play an important role in promoting CAD in HIV.
Disclosure of interest statement No commercial funding was involved in this project.