e24
differences remain in such risk factors as body mass index and diastolic
blood pressure. In carriers of IL-6 -174G / G in the genotype, the differ-
ences in these parameters are more significant. The difference in the levels
of systolic blood pressure between patients and healthy, characteristic of the
general groups, is detected only for patients with IL-6 -174 G / C and IL-6
-174G / G genotypes. When comparing a group of smoking patients with
healthy nonsmokers, the presence of IL-6 -174C / C in the genotype was an
additional risk factor for the disease.
Conclusions: Therefore, it can be assumed that the analyzed IL6 gene poly-
morphism can be considered as a genetic risk factor for the development of
CVD in the Uzbek population, as an additional constitutional factor of pre-
disposition to the development of vascular lesions.
Lipid Management in Special Populations
267
Statin prescribing for primary prevention
among people living with HIV
Joseph Nardolillo, PharmD(Detroit, MI),
Joel Marrs, PharmD, MPH, Sarah Anderson, PharmD,
Joseph Saseen, PharmD, Rebecca Hanratty, MD
Lead Author’s Financial Disclosure: Nothing to disclose
Study Funding: None.
Background/Synopsis: People living with HIV (PLWH) are at higher
risk of atherosclerotic cardiovascular disease (ASCVD) than patients with-
out HIV. Chronic inflammatory conditions, including HIV, were included
as a risk-enhancing factors within the 2018 American Heart Association
(AHA)/American College of Cardiology (ACC)/Multisociety guideline for
primary prevention because the Pooled Cohort Equation (PCE) to determine
10-year ASCVD risk does not account for such factors.
Objective/Purpose: To compare statin prescribing rates between
intermediate-risk PLWH and intermediate-risk patients without a di-
agnosis of HIV.
Methods: This retrospective cohort study aimed to determine the difference
in proportions of statin prescribing for primary prevention of ASCVD be-
tween PLWH and patients without HIV within Denver Health. Electronic
health record data were used to identify a cohort of PLWH aged 40-75 years
with a calculated 10-year ASCVD risk between 7.5%-19.9% as determined
by the PCE. A matched cohort of primary prevention non-HIV patients was
identified. The primary outcome was the proportion of PLWH who were pre-
scribed statin therapy compared to patients who were not living with HIV
and were prescribed statin therapy.
Results: 81 patients meeting study criteria in the PLWH cohort were
matched to 81 non-HIV patients. The proportion of patients prescribed
statins was 33.0% and 30.9% in the PLWH and non-HIV cohorts, respec-
tively (p=0.74).
Conclusions: This study evaluated statin prescribing in PLWH for primary
prevention of ASCVD as described in the 2018 AHA/ACC/Multisociety
guideline. Rates of statin prescribing were similar, yet overall low, among
primary prevention PLWH compared to those not diagnosed with HIV.
Journal of Clinical Lipidology, Vol 15, No , Month 2021
Clinical Applications of Biomarkers,
Lipoprotein Testing
268
Lipid Biomarkers Associated with
Mortality in COVID-19
Karolyn Teufel, MD(Washington, DC), Shant Ayanian, MD,
Tim Shields, JD, Mohammad Shirazi, MD,
Michael Porter, MD, Matthew Petersen, MD,
Sabyasachi Sen, MD PhD
Lead Author’s Financial Disclosure: Nothing to disclose.
Study Funding: None.
Background/Synopsis: Limited literature and anecdotal observation indi-
cate that an unusual dyslipidemia possibly occurs during acute COVID-19
infection. Viruses are known to utilize host bioavailable lipoproteins for their
replication. Further, dyslipidemia has been associated with COVID-19 in-
fection severity.
Objective/Purpose: We examined whether certain lipid cutoff values were
associated with COVID-19 mortality, and further whether statin use had any
effect on mortality in a US cohort.
Methods: After IRB approval, patient data (demographics, comorbidities,
lab data, and clinical outcomes) were extracted from the electronic medical
record. We performed univariate and multivariate logistic regression analy-
sis on a cohort of 403 patients hospitalized for COVID-19 at a university hos-
pital in Washington, DC. 254 patients had random lipid measurements per-
formed during their hospital stay. Measurements of lipids were performed
solely at the clinician’s discretion. Low-density lipoprotein (LDL) levels,
high-density lipoprotein (HDL) levels, and triglyceride (TG) levels were
transformed into categorical variables with thresholds of 50mg/dL for LDL,
40mg/dL for HDL, and 150mg/dL for TG.
Results: Our patient population had an average age of 61.8 years (22-103),
53.5% were male, 70% were Black or African American, and average BMI
was 29.9 (12.9-60.6). 47.6% of our COVID-19 patients had diabetes, with
average Hgb A1c 7.6% (5.1-14). Univariate regression analysis of LDL and
survival in our cohort (n=239) showed a significantly increased odds of mor-
tality when the direct low-density lipoprotein (LDL) was below 50mg/dL at
any point during the hospital stay (OR 3.73 [CI 1.85-7.51]). Similar anal-
ysis of triglyceride (TG) and mortality showed significantly higher odds of
death when the maximum TG was greater than 150mg/dL (OR 4.32 [CI
2.35-7.97]). HDL values lower than 40mg/dL showed a trend towards higher
mortality, however, this effect was not statistically significant. Statin use
had no overall association with mortality; further, statin use was not associ-
ated with mortality when analyzed in the subgroups of LDL above or below
50mg/dL. Multivariate regression analysis confirmed these lipid and mortal-
ity associations remained significant even when controlling for other known
risk factors for mortality in COVID-19 infection, such as heart disease and
diabetes.
Conclusions: LDL concentration below 50mg/dl and TG above 150mg/dl
concentrations, individually, were significantly associated with increased
mortality in COVOD-19 subjects. Lipid profile measurements during hos-
pitalization for COVID-19 infection can be a valuable clinical tool for iden-
tifying patients at increased risk of mortality.