Scientific article

Biomarkers and electrocardiographic evidence of myocardial ischemia in patients with human immunodeficiency virus infection

Published inThe American journal of cardiology, vol. 111, no. 5, p. 760-764
Publication date2013

We assessed the relation of inflammatory and coagulation biomarkers with electrocardiographic (ECG) evidence of myocardial ischemia. High-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and D-dimer levels were measured at study entry for 3,085 human immunodeficiency virus-infected participants (mean age 44 years; 26.4% women; 24.6% black) in the Strategies for Management of Antiretroviral Therapy trial. Logistic regression models were used to examine the associations of these biomarkers with prevalent and incident myocardial ischemia. The latter analyses were performed for 1,411 participants who were randomly assigned to receive continuous antiretroviral therapy during follow-up to suppress the human immunodeficiency virus viral load and had ≥1 ECG reading during the follow-up period. The median hsCRP, IL-6, and D-dimer level was 1.65 μg/ml (interquartile range 0.69 to 4.11), 1.60 pg/ml (interquartile range 1.00 to 2.75), and 0.18 μg/ml (interquartile range 0.11 to 0.32), respectively. At baseline, the prevalence of major or minor Q-QS or ST-T ECG abnormalities was 18.6%. The biomarker levels were associated with prevalent major or minor ischemic abnormalities on the univariate analyses; however, adjustment for traditional risk factors attenuated these associations. The adjusted odds ratio for major or minor ischemic abnormalities and 95% confidence intervals for the greatest versus lowest quartiles was 1.3 (95% confidence interval 0.9 to 1.7) for hsCRP, 1.0 (95% confidence interval 0.7 to 1.3) for IL-6, and 1.1 (95% confidence interval 0.9 to 1.5) for D-dimer. During a median follow-up of 2.3 years, new definite or probable ischemic ECG abnormalities developed in 11.7% of participants receiving continuous antiretroviral therapy. Biomarker levels were not associated with incident abnormalities on unadjusted or adjusted analyses. In conclusion, higher levels of hsCRP, IL-6, and D-dimer were not associated with ischemic ECG abnormalities. Elevated biomarker levels and ECG abnormalities indicating myocardial ischemia might reflect different risk pathways for cardiovascular disease.

  • Adult
  • Anti-HIV Agents/therapeutic use
  • Biological Markers/blood
  • C-Reactive Protein/metabolism
  • Cross-Sectional Studies
  • DNA, Viral/analysis
  • Electrocardiography
  • Female
  • Fibrin Fibrinogen Degradation Products/metabolism
  • Follow-Up Studies
  • HIV/genetics
  • HIV Infections/blood/complications/drug therapy
  • Humans
  • Incidence
  • Interleukin-6/blood
  • Male
  • Middle Aged
  • Myocardial Ischemia/blood/complications/epidemiology
  • Odds Ratio
  • Prognosis
  • Risk Factors
  • United States/epidemiology
Research group
Citation (ISO format)
GUPTA, Mihir et al. Biomarkers and electrocardiographic evidence of myocardial ischemia in patients with human immunodeficiency virus infection. In: The American journal of cardiology, 2013, vol. 111, n° 5, p. 760–764. doi: 10.1016/j.amjcard.2012.11.032
Main files (1)
Article (Published version)
ISSN of the journal0002-9149

Technical informations

Creation12/03/2013 11:27:00 AM
First validation12/03/2013 11:27:00 AM
Update time03/14/2023 8:56:08 PM
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