{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:10:14Z","timestamp":1791216614832,"version":"4.1.0"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,5,7]]},"abstract":"\n Background<\/jats:title>\n \n People living with\n HIV<\/jats:styled-content>\n (\n PLWH<\/jats:styled-content>\n ) have an increased risk of myocardial infarction (\n MI<\/jats:styled-content>\n ). Changes in the gut microbiota that occur with chronic\n HIV<\/jats:styled-content>\n infection could play a role in\n HIV<\/jats:styled-content>\n \u2010associated atherosclerosis. Choline, carnitine, betaine, and trimethylamine N\u2010oxide are small molecules that are, in part, metabolized or produced by the gut microbiome. We hypothesized that these metabolites would be associated with carotid artery intima\u2010media thickness and\n MI<\/jats:styled-content>\n in\n PLWH<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Carotid artery intima\u2010media thickness was measured at baseline and at a median interval of 4\u00a0years in 162\n PLWH<\/jats:styled-content>\n from the\n SCOPE<\/jats:styled-content>\n (Study of the Consequences of the Protease Inhibitor Era) cohort in San Francisco,\n CA<\/jats:styled-content>\n . Separately, 105\n PLWH<\/jats:styled-content>\n (36 cases with type I adjudicated\n MI<\/jats:styled-content>\n and 69 controls without\n MI<\/jats:styled-content>\n ) were selected from the Center for AIDS Research Network of Integrated Clinical Systems, a multicenter clinic\u2010based cohort. Controls were matched by demographics,\n CD<\/jats:styled-content>\n 4 cell count, and duration of viral suppression. In the\n SCOPE<\/jats:styled-content>\n cohort, higher carnitine levels had a significant association with presence of carotid plaque and greater baseline and progression of mean carotid artery intima\u2010media thickness after adjusting for traditional cardiovascular disease risk factors. In the treated and suppressed subgroup, these associations with carnitine remained significant after adjustment for cardiovascular disease risk factors. In the Center for AIDS Research Network of Integrated Clinical Systems cohort, the risk of\n MI<\/jats:styled-content>\n was significantly increased in subjects with carnitine levels in the highest quartile after adjustment for cardiovascular disease risk factors.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In\n PLWH<\/jats:styled-content>\n , including the treated and suppressed subgroup, carnitine is independently associated with carotid artery intima\u2010media thickness, carotid plaque, and\n MI<\/jats:styled-content>\n in 2 separate cohorts. These results emphasize the potential role of gut microbiota in\n HIV<\/jats:styled-content>\n \u2010associated atherosclerosis and\n MI<\/jats:styled-content>\n , especially in relation to carnitine metabolism.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.011037","type":"journal-article","created":{"date-parts":[[2019,4,27]],"date-time":"2019-04-27T09:00:20Z","timestamp":1556355620000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Carnitine Is Associated With Atherosclerotic Risk and Myocardial Infarction in HIV\u2010Infected Adults"],"prefix":"10.1161","volume":"8","author":[{"given":"Arjun","family":"Sinha","sequence":"first","affiliation":[{"name":"Department of Medicine Northwestern University Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yifei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Medicine San Francisco Veterans Affairs Medical 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