Coronary Plaque, Inflammation, Subclinical Myocardial Injury, and Major Adverse Cardiovascular Events in the REPRIEVE Substudy
Authors' conclusion
NCP and higher hs-CRP, IL-6, and hs-cTnT were associated with MACE and improved risk prediction over traditional risk factors in people with HIV without cardiac symptoms and low-to-moderate ASCVD risk. (Evaluating the Use of Pitavastatin to Reduce the Risk of Cardiovascular Disease in HIV-Infected Adults [REPRIEVE]; NCT02344290).
Study context
- Population
- People with HIV without cardiac symptoms and low-to-moderate ASCVD riskREPRIEVE Mechanistic Substudy participants enrolled from April 2015 to February 2018
- Participants
- 804 people
- Comparison
- Relationships of baseline noncalcified coronary plaque (NCP), markers of inflammation and subclinical myocardial injury with major adverse cardiovascular events (MACE)
- With noncalcified plaquen = 299/755
Methodological details31 U.S. sites, randomized to pitavastatin 4 mg/day or placebo
- 31 U.S. sites
- Randomized to pitavastatin 4 mg/day or placebo
Primary result
As reported in the abstract
MACE incidence · median 6.2 years [Q1-Q3 5.4-7.1]
Pitavastatin
7.26/1,000
17 events
Placebo
9.15/1,000
21 events
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Hazard of MACE by baseline noncalcified plaque and biomarkersWith noncalcified plaque vs without noncalcified plaque · persisting after ASCVD risk adjustment | 2.5 (1.3–4.8) | P = 0.008 | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | ASCVD risk + hs-CRP, IL-6, hs-cTnT | ASCVD risk alone |
|---|---|---|
| Exploratory prediction modeling: ASCVD risk plus hs-CRP, IL-6 and hs-cTnT vs ASCVD risk aloneExploratory | ||
| Integrated area under the curve | 0.72 | 0.58 |
| C-statistic | 0.73 (0.62-0.84) | 0.56 (0.45-0.67) |
- Hazard of MACE by baseline noncalcified plaque and biomarkers — Higher hs-CRP at study entry
- P = 0.049
- Hazard of MACE by baseline noncalcified plaque and biomarkers — Higher IL-6 at study entry
- P = 0.033
- Hazard of MACE by baseline noncalcified plaque and biomarkers — Higher hs-cTnT at study entry
- P = 0.003
Original publication
Coronary Plaque, Inflammation, Subclinical Myocardial Injury, and Major Adverse Cardiovascular Events in the REPRIEVE Substudy. JACC Adv. Published 14 May 2025. doi:10.
Summarised from the published abstract; every number is checked against it