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Coronary revascularization in patients with HIV
Keir McCutcheon1, Andreas S Triantafyllis2, Jef Van den Eynde3
1Department of Cardiovascular Medicine, University Hospitals Leuven, Belgium; Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
Trends in Cardiovascular Medicine
|February 24, 2021
Summary
People living with HIV (PLWH) face increased cardiovascular risks. Optimal coronary revascularization strategies for PLWH with atherosclerosis are still under investigation, highlighting a need for comparative data.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- People living with HIV (PLWH) have longer lifespans due to combined antiretroviral therapy.
- Cardiovascular diseases are now a leading cause of mortality in PLWH.
- PLWH with ST-segment elevation myocardial infarction have high thrombus burden and adverse event risks.
Purpose of the Study:
- To review current data on coronary revascularization strategies in PLWH.
- To identify the need for comparative studies on percutaneous versus surgical revascularization in PLWH.
- To address the knowledge gap regarding optimal revascularization in PLWH with atherosclerosis.
Main Methods:
- Literature review of studies on coronary revascularization in people living with HIV.
- Analysis of data on major adverse cardiovascular events following revascularization in PLWH.
- Synthesis of available evidence comparing different revascularization approaches.
Main Results:
- Revascularization in PLWH with stable coronary artery disease is linked to increased adverse events.
- Higher risks of stent thrombosis and in-stent restenosis are observed post-revascularization.
- Limited data exists comparing percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) in PLWH.
Conclusions:
- Optimal coronary revascularization strategies for PLWH require further investigation.
- Comparative studies on PCI versus CABG in PLWH are crucial.
- Addressing cardiovascular risks is essential for long-term health in the aging PLWH population.
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