Associations between Tobacco, Alcohol, and Drug Use with Coronary Artery Plaque among HIV-Infected and Uninfected Men in the Multicenter AIDS Cohort Study

• Published in: PloS one Vol. 11; no. 1; p. e0147822
• Main Authors: Kelly, Sean G, Plankey, Michael, Post, Wendy S, Li, Xiuhong, Stall, Ronald, Jacobson, Lisa P, Witt, Mallory D, Kingsley, Lawrence, Cox, Christopher, Budoff, Matthew, Palella, Jr, Frank J
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 26.01.2016; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; AIDS; Alcohol Drinking; Alcohol use; Alcoholic beverages; Alcohols; Analysis; Arteriosclerosis; Biology and Life Sciences; Calcification (ectopic); Calcium; Cannabis; Cardiovascular disease; Cocaine; Cohort analysis; Cohort Studies; Complications and side effects; Computed tomography; Coronary Angiography; Coronary artery; Coronary Artery Disease - diagnosis; Coronary Artery Disease - etiology; Coronary heart disease; Demographic aspects; Drinking (Alcoholic beverages); Drug abuse; Drug addiction; Drugs; Erectile dysfunction; Health aspects; Health risk assessment; HIV; HIV Infections - complications; HIV patients; Human immunodeficiency virus; Humans; Linear Models; Logistic Models; Male; Marijuana; MDMA; Medical imaging; Medicine and Health Sciences; Men; Methamphetamine; Middle Aged; Nitrites; Odds Ratio; Plaque, Atherosclerotic; Prospective Studies; Recreational use; Regression analysis; Regression models; Research and Analysis Methods; Risk Factors; Scanning; Smoking; Smoking cessation; Stenosis; Substance-Related Disorders - complications; Tobacco; Tobacco habit; Tomography, X-Ray Computed; United States; Los Angeles California; United States > US; Illinois; California; Pittsburgh Pennsylvania; Chicago Illinois; Maryland; Baltimore Maryland; Pennsylvania
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0147822

We characterized associations between smoking, alcohol, and recreational drug use and coronary plaque by HIV serostatus within the Multicenter AIDS Cohort Study (MACS). MACS participants (N = 1005, 621 HIV+ and 384 HIV-) underwent non-contrast CT scanning to measure coronary artery calcium; 764 underwent coronary CT angiograms to evaluate plaque type and extent. Self-reported use of alcohol, tobacco, smoked/inhaled cocaine, methamphetamine, ecstasy, marijuana, inhaled nitrites, and erectile dysfunction drugs was obtained at semi-annual visits beginning 10 years prior to CT scanning. Multivariable logistic and linear regression models were performed, stratified by HIV serostatus. Among HIV+ men, current smoking, former smoking, and cumulative pack years of smoking were positively associated with multiple coronary plaque measures (coronary artery calcium presence and extent, total plaque presence and extent, calcified plaque presence, and stenosis >50%). Smoking was significantly associated with fewer plaque measures of comparable effect size among HIV- men; current smoking and calcified plaque extent was the only such association. Heavy alcohol use (>14 drinks/week) was associated with stenosis >50% among HIV+ men. Among HIV- men, low/moderate (1-14 drinks/week) and heavy alcohol use were inversely associated with coronary artery calcium and calcified plaque extent. Few significant associations between other recreational drug use and plaque measures were observed. Smoking is strongly associated with coronary plaque among HIV+ men, underscoring the value of smoking cessation for HIV+ persons. Alcohol use may protect against coronary artery calcium and calcified plaque progression in HIV- (but not HIV+) men. Few positive associations were observed between recreational drug use and coronary plaque measures.