Elevated D-dimer is independently associated with endothelial dysfunction: a cross-sectional study in HIV-infected adults on antiretroviral therapy.

Hileman CO, Longenecker CT, Carman TL, Milne GL, Labbato DE, Storer NJ, White CA, McComsey GA
Antivir Ther. 2012 17 (7): 1345-9

PMID: 22878464 · DOI:10.3851/IMP2297

BACKGROUND - D-Dimer elevations have been associated with a striking increase in mortality in HIV-infected patients. However, D-Dimer has not been directly linked to endothelial dysfunction in HIV.

METHODS - In this cross-sectional study, we used flow-mediated dilation (FMD) of the brachial artery to measure endothelial function and several biomarkers to measure systemic inflammation and coagulation activation in HIV-infected adults on stable antiretroviral therapy with HIV-1 RNA levels <400 copies/ml. Multivariable linear regression was used to model FMD by these markers, traditional cardiovascular risk factors and HIV-related characteristics.

RESULTS - Analysis included 98 subjects (88% male, median age 47.5 years, CD4(+) T-cells 578.5 cells/mm(3)); all on ART (52% on protease inhibitors). The only factors independently associated with FMD were D-Dimer and body mass index.

CONCLUSIONS - We show for the first time an independent association between D-Dimer and endothelial dysfunction in virologically suppressed, HIV-infected adults on stable antiretroviral therapy, potentially explaining the link between D-Dimer and mortality in HIV.

MeSH Terms (24)

Adult Biomarkers Body Mass Index Brachial Artery Cardiovascular Diseases CD4 Lymphocyte Count Cross-Sectional Studies Endothelium, Vascular Female Fibrin Fibrinogen Degradation Products HIV-1 HIV Infections HIV Protease Inhibitors Humans Inflammation Interleukin-6 Linear Models Male Middle Aged Models, Cardiovascular Risk Factors RNA, Viral Ultrasonography Vasodilation

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