Brief report: Mycobacterium tuberculosis infection and acute or subclinical coronary artery disease: the Swiss HIV Cohort Study
This brief report from the Swiss HIV Cohort Study investigates whether Mycobacterium tuberculosis (MTB) infection is associated with acute coronary artery disease (CAD), or subclinical atherosclerosis in people living with HIV (PLWH) in a low tuberculosis (TB) prevalence setting like Switzerland.
While previous research in TB-endemic regions suggested a possible link between MTB infection and increased cardiovascular risk, this study aimed to explore whether the same holds true in low-incidence areas.
The study included two analyses: one on clinical CAD events and another on subclinical coronary atherosclerosis (coronary artery calcification, and coronary soft, mixed, or high-risk plaque). For clinical CAD, 465 SHCS participants with a first CAD event were compared to 1123 matched controls. For subclinical disease, 402 participants underwent coronary imaging. The researchers performed univariable and multivariable analyses to obtain odds ratio (ORs) for CAD, coronary artery calcification, and coronary soft, mixed, or high-risk plaque.
Results showed no evidence for an association between MTB infection and either acute CAD events or indicators of subclinical atherosclerosis. The aOR for CAD was 0.92 (confidence interval: 0.55 to 1.52); aOR for coronary soft, mixed, or high-risk plaque was 0.55 (CI: 0.19 to 1.55); aOR for coronary artery calcification was 0.38 (CI: 0.1 to 1.41).
In conclusion, MTB infection does not appear to increase the risk of either clinical or subclinical coronary artery disease in a low TB incidence setting among people with well-managed HIV.