Related Experiment Videos
Coronary artery disease in HIV infected patients
Lelia Escaut1, Jean Jacques Monsuez1, Gilles Chironi2
1Service des Maladies Infectieuses, Hôpital Paul Brousse, 12-14 avenue Paul Vaillant Couturier, 94804, Villejuif, France.
Insights
HIV-infected patients experience a higher rate of coronary events, often linked to metabolic issues from treatment and smoking. The prognosis for acute myocardial infarction in this group is similar to the general population.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Coronary events represent a significant concern in the management of Human Immunodeficiency Virus (HIV) infection.
- Understanding the specific risks and outcomes of cardiovascular disease in HIV-positive individuals is crucial for optimizing care.
Purpose of the Study:
- To investigate the incidence, clinical characteristics, management, and long-term outcomes of coronary events in a cohort of HIV-infected patients over a five-year period.
Main Methods:
- A prospective cohort study involving 840 HIV-infected patients was conducted.
- Data collected included patient demographics, CD4 T-cell counts, lipid profiles, and details of coronary events and their management.
Main Results:
- The incidence of coronary events was 5.9 per 1000 person-years, with 16 of 17 events occurring in patients on highly active antiretroviral therapy (HAART).
- Patients experiencing coronary events were older and had significantly different cholesterol levels (higher total and LDL, lower HDL) and CD4 counts compared to controls.
- Acute coronary syndrome was the initial presentation in most cases, with percutaneous coronary intervention and stenting being common interventions.
Conclusions:
- HIV-infected patients exhibit an elevated risk of coronary events, associated with HAART-induced metabolic disturbances and smoking.
- Despite the increased incidence, the treatment and prognosis for acute myocardial infarction in this population do not appear to differ from the general population.
Objective:
To assess the incidence, clinical features, treatment, and follow-up of coronary events in HIV-infected patients over a period of 5 years.
Patients And Participants:
A cohort of 840 patients.
Measurements And Results:
A coronary event occurred in 17 patients (5.9/1000 persons-years). Sixteen of them were exposed to highly active antiretroviral therapy (HAART). Patients with coronary events differed in age (48.3 vs. 43 years), CD4 T-cell count (284 vs. 486/mm(3)), total cholesterol (6.2 vs. 5.3 mmol/l), HDL cholesterol (0.72 vs. 1.16 mmol/l), and LDL cholesterol (4.95 vs. 3.391.61 mmol/l). No difference was observed regarding duration of HAART, weight, glucose level, or smoking status between the two groups. Acute coronary syndrome was the first manifestation in 14 patients. Coronary angiography showed 2.56 stenosis per patient, with a single vessel involvement in one-half. Percutaneous angioplasty was performed in all cases, with stenting in 11. After a mean follow-up of 36 months, 14 patients remain alive. Restenosis ( n=4) occurred in 3 patients (PTCA 3; stenting 4). All 14 patients are free of heart failure symptoms. Their mean left ventricular ejection fraction is 61%.
Conclusions:
A higher coronary-event rate is observed among HIV-infected patients, associated with drug-induced metabolic disturbances and a high prevalence of tobacco smoking. However, treatment and prognosis of acute myocardial infarction has no specificity.