Risk factors and surrogate indicators for cardiovascular disease are prevalent in Common Variable Immunodeficiency and associate with inflammatory phenotype.

CVID patients demonstrated high rates of traditional cardiovascular risk factors.

• Hyperlipidaemia was present in 38.6% of CVID patients
• Hypertension was present in 23.8% of CVID patients
• Diabetes or prediabetes was present in 14.9% of CVID patients
• A total of 101 CVID patients and 56 matched household controls were recruited

Coronary artery calcification (CAC) was present in 37% of CVID patients, the majority of whom had no known prior cardiovascular disease.

• CAC was identified in 37% of CVID patients on thoracic CT imaging
• 82.4% of patients with CAC had no known prior cardiovascular disease
• CAC was assessed using existing thoracic CT imaging reviewed as part of the study

Patients with CAC were older and had higher rates of comorbidities and elevated endothelial dysfunction biomarkers compared to those without CAC.

• Patients with CAC had higher rates of hypertension, diabetes, hyperlipidaemia, and chronic kidney disease
• Median vWF was significantly higher in patients with CAC versus without (227.5 vs 167 IU/dL, p=0.001)
• Median D-dimer was significantly higher in patients with CAC versus without (370.5 vs 271 ng/mL, p=0.011)
• Aortic pulse wave velocity (aPWV) was higher in patients with CAC (8.2 vs 6.0 m/s, p=0.006)

Hepatic steatosis and elevated aortic pulse wave velocity were observed in subsets of CVID patients.

• Hepatic steatosis was observed in 30% of CVID patients as assessed by FibroScan controlled attenuation parameter (CAP) scores
• Elevated aPWV was observed in 6.5% of CVID patients
• aPWV was measured in a subset of participants only

CVID patients with an inflammatory or complex phenotype had significantly higher levels of endothelial dysfunction biomarkers than those with an infection-only phenotype.

• Patients with inflammatory phenotype had higher vWF than infection-only patients (224 vs 163 IU/dL, p<0.001)
• Patients with inflammatory phenotype had higher D-dimer than infection-only patients (314 vs 205 ng/mL, p=0.043)
• Subgroup analysis compared infection-only versus inflammatory/complex phenotypes of CVID
• Blood biomarkers collected included D-dimer, von Willebrand factor, fibrinogen, ESR, and CRP