N/A
N=40
Statin Therapy to Improve Atherosclerosis in HIV Patients
Cardiovascular Disease · HIV · Atherosclerosis · Inflammation · Statins, HMG-CoA
Bottom Line
View on ClinicalTrials.gov: NCT00965185 ↗Enrolled (actual)
40
Serious AEs
7.5%
Results posted
Feb 2015
Primary outcome: Primary: Coronary and Aortic Plaque Inflammation — 0.04; -0.05; -0.03; -0.06 ratio
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- atorvastatin (Drug); Placebo (Drug)
- Age
- Adult · 18+ yrs
- Sex
- All
- Sponsor
- Massachusetts General Hospital
- Primary completion
- Jan 2014
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Coronary and Aortic Plaque Inflammation |
0.04; -0.05; -0.03; -0.06 | — |
| SECONDARY Plaque Progression |
-4.7; 18.2; -19.4; 20.4 | — |
| SECONDARY Endothelial Function |
— | — |
| SECONDARY Immune Function |
17; 4 | — |
| SECONDARY Lipid Profile |
-1.23; 0.12; 0.02; -0.04; -1.00; 0.30 | — |
| SECONDARY C-reactive Protein (CRP) |
-0.3; 0.1 | — |
| SECONDARY Adipocytokines |
-1.25; 0.41 | — |
| SECONDARY Liver Function Tests (LFTs) |
3; 2 | — |
Summary
In HIV patients, statin therapy will attenuate plaque inflammation, thus, making plaques less vulnerable, will deter plaque progression, and improve endothelial function. In addition to known cholesterol-lowering and C-reactive protein lowering effects, immunomodulatory effects of statins will lead to a shift from pro-inflammatory monocyte and T cell subsets to less atherogenic subpopulations.
Eligibility Criteria
Inclusion criteria
- Men and women age 18-60 with previously diagnosed HIV disease
- Subclinical coronary artery disease as defined by presence of one or more plaque on coronary CTA without history of cardiac events or cardiac symptoms and no evidence of critical coronary stenosis. Target to background ratio (TBR) as determined by PET of > 1.6.
- Stable anti-retroviral (ARV) therapy as defined by no changes in ARV regimen for >6 months
- LDL-cholesterol >70 mg/dL and 1.5 mg/dL (given the risk of contrast nephropathy during CT angiography of the heart)
- Infectious illness within past 3 months
- Contraindication to beta-blocker (including moderate to severe asthma or heart block) or nitroglycerin use as these drugs are given as part of the standard cardiac CT protocol. Previous allergic reaction to beta blocker or nitroglycerin.
- Body weight greater than 300 lbs due to CT scanner table limitations
- Patients with previous allergic reactions to iodine-containing contrast media
- Active illicit drug use
- Patients who report any significant radiation exposure over the course of the year prior to randomization. Significant exposure is defined as:
- More than 2 percutaneous coronary interventions (PCI) within 12 months of randomization
- More than 2 myocardial perfusion studies within the past 12 months
- More than 2 CT angiograms within the past 12 months
- Any subjects with history of radiation therapy.
- Patients already scheduled or being considered for a procedure or treatment requiring significant radiation exposure (e.g., radiation therapy, PCI, or catheter ablation of arrhythmia) within 12 months of randomization
- Pregnancy or breastfeeding
- Coronary artery luminal narrowing >70% seen on coronary CTA
Data sourced from ClinicalTrials.gov (NCT00965185). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.