Statin Effects on Pericoronary Adipose Tissue Density in People With HIV: Insights From the REPRIEVE Trial
Authors' conclusion
PCAT density increases over time in PWH, but pitavastatin mitigates this in those with high coronary artery disease burden. PCAT density is associated with vulnerable plaque morphology and all-cause mortality, supporting its potential as a prognostic imaging biomarker in PWH.
Study context
- Population
- People with HIV (mean age 51 ± 6 years, 17% women)
- Participants
- 753 people
- Comparison
- Pitavastatin vs placebo
- Primary endpoint
- PCAT density change over time; statin effects on PCAT; associations with coronary plaque and clinical outcomes
- Follow-up
- 2 years
Methodological detailsmechanistic computed tomographic (CT) substudy
- Mechanistic CT substudy
Primary result
As reported in the abstract
PCAT density
Baseline pericoronary adipose tissue (PCAT) density (HU)
−87.7 ± 10.5
Increase in PCAT density over 2 years, HU
4.5
95% CI 3.8–5.2; P < 0.001
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| All-cause mortality, per +10 HU baseline PCAT density · median 6.3 years4.2% died; not associated with MACE | 1.95 (1.03–3.69) | P = 0.040 | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Pitavastatin | Placebo | P value |
|---|---|---|---|
| PCAT density change, segment involvement score ≥4 (subgroup) · 2 years | −1.7 HU | +3.8 HU | P = 0.016 |
Plaque, per +10 HU PCAT density
- Noncalcified plaque volume, mm3 (P = 0.075)
- +5.0
- Calcified plaque progression, mm3 (P = 0.031)
- −3.2
Original publication
Statin Effects on Pericoronary Adipose Tissue Density in People With HIV: Insights From the REPRIEVE Trial. JACC Cardiovasc Imaging. Published 1 December 2025. doi:10.
Summarised from the published abstract; every number is checked against it