Clinical characteristics and mid-term prognosis of acute coronary syndrome in HIV-infected patients on antiretroviral therapy
- 1 July 2005
- journal article
- Published by Wiley in HIV Medicine
- Vol. 6 (4), 240-244
- https://doi.org/10.1111/j.1468-1293.2005.00283.x
Abstract
Acute coronary syndromes (ACSs) and coronary artery disease are emerging complications in HIV-infected patients on highly active antiretroviral treatment. The aim of this study was to determine the mid-term prognosis of ACS in HIV-infected patients. We evaluated the clinical characteristics and follow-up profile [38+/-15 months; mean+/-standard deviation (SD)] of ACS in 20 HIV-infected patients (mean +/-SD: age 44+/-8 years; range 35-65 years). All had coronary angiograms performed mean time 3+/-48 h after the onset of symptoms. Eighteen patients were on antiretroviral therapy, of whom 13 patients were on regimens including protease inhibitors (mean duration+/-SD: 19+/-13 months). Fifteen patients had a first episode of ST segment elevation ACS and five had non-ST segment elevation ACS. Tobacco consumption (80%) and hypercholesterolaemia (50%) were the most frequent cardiovascular risk factors. During initial hospitalization, four patients were treated with thrombolysis, two had primary coronary angioplasty and seven had secondary coronary angioplasty. At follow up, 10 patients (50%) had had 18 cardiovascular events: one cardiovascular death, seven episodes of recurrent myocardial ischaemia in four patients, three pulmonary oedemas in two patients, and seven revascularization procedures in five patients. This preliminary report highlights the risk of ACS and related complications in HIV-infected patients and raises questions regarding the implications of antiretroviral treatment.Keywords
This publication has 29 references indexed in Scilit:
- Clinical Features of Acute Coronary Syndromes in Patients With Human Immunodeficiency Virus InfectionCirculation, 2004
- Increased risk of myocardial infarction with duration of protease inhibitor therapy in HIV-infected menAIDS, 2003
- Guidelines for the Evaluation and Management of Dyslipidemia in Human Immunodeficiency Virus (HIV)-Infected Adults Receiving Antiretroviral Therapy: Recommendations of the HIV Medicine Association of the Infectious Disease Society of America and the Adult AIDS Clinical Trials GroupClinical Infectious Diseases, 2003
- The Pavia consensus statementAIDS, 2003
- Coronary artery calcification, atherogenic lipid changes, and increased erythrocyte volume in black injection drug users infected with human immunodeficiency virus-1 treated with protease inhibitorsAmerican Heart Journal, 2002
- Clinical Evaluation and Management of Metabolic and Morphologic Abnormalities Associated with Human Immunodeficiency VirusClinical Infectious Diseases, 2002
- Ischemic Cardiovascular Disease in Persons with Human Immunodeficiency Virus InfectionClinical Infectious Diseases, 2002
- Coronary heart disease associated with the use of human immunodeficiency virus (HTV)‐1 protease inhibitors: Report of four cases and reviewClinical Cardiology, 2001
- Pathogenesis of HIV-1-protease inhibitor-associated peripheral lipodystrophy, hyperlipidaemia, and insulin resistanceThe Lancet, 1998
- Normal angiogram after myocardial infarction in young patients:: A prospective clinical-angiographic and long-term follow-up studyInternational Journal of Cardiology, 1997