Acute Coronary Thrombosis and Multiple Coronary Aneurysms in a 22-Year-Old Man with the Human Immunodeficiency Virus

Ayers, Jennifer; Mandell, Ryan; Sanghvi, Kintur; Aboujaoude, Rania; Hsi, David H.

doi:10.14503/thij-13-3160

Cited by 9 publications

(8 citation statements)

References 12 publications

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“…We believe that the hypercoagulability state in this patient was high and contributed to this clinical event. In a similar way, we believe that our patient also had a high state of hypercoagulability [12].…”

Section: Discussionmentioning

confidence: 54%

Very Early Coronary Artery Aneurysm After Primary Percutaneous Coronary Intervention in Patient With HIV and Thrombophilia

Oliveira

Miranda

et al. 2019

Cardiol Res

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The incidence of coronary artery aneurysms ranges from 0.2% to 10.5%. Aneurysms have been described after percutaneous coronary interventions (PCIs) and hypersensitivity to polymers, nickel, cobalt, inflammatory reaction rich in eosinophils, drug released by the stent, fracture and malapposition of the stent, stent endothelialization delay, high pressures used in the procedures, oversizing of balloons and stents, unhealed dissections, atheroablative techniques, and trauma of the arterial wall are related to appearance of coronary artery aneurysms. In this case report, we described a patient with human immunodeficiency virus and thrombophilia who underwent primary PCI and at the end of the procedure had thrombi in the coronary artery. It was decided by triple therapy and new angiographic study 2 days later. This new angiography revealed thrombi resolution but the appearance of an aneurysm in the middle portion of the drug-eluting stent. The anticoagulant was stopped and we performed watchful waiting strategy with new serial angiograms that revealed progressive reduction and disappearance of the aneurysm. Subsequently triple therapy with warfarin, aspirin and clopidogrel was restarted and the patient progressed asymptomatic and performed his daily activities normally. At 6 months of clinical follow-up, we advised the patient to suspend aspirin and to continue secondary prevention of cardiovascular events.

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Section: Discussionmentioning

confidence: 54%

Very Early Coronary Artery Aneurysm After Primary Percutaneous Coronary Intervention in Patient With HIV and Thrombophilia

Oliveira

Miranda

et al. 2019

Cardiol Res

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“…Infection by HIV also results in diffuse endothelial dysfunction affecting multiple organ systems including the coronary arteries [ 10 ]. Although less is known about the association between HIV and coronary aneurysms, extra-cranial arterial aneurysms in the context of HIV have been well-described [ 11 ], and coronary artery aneurysms have been reported in patients with acquired immunodeficiency syndrome [ 12 , 13 ] and other vasculitides [ 14 , 15 ]. We report what we believe to be the first described case of both coronary stenosis and coronary artery aneurysms in a person living with HIV.…”

Section: Introductionmentioning

confidence: 99%

Coronary artery aneurysm, ectasia and stenosis in a 53-year-old man with HIV infection

Kashyap

Abramov

Bharadwaj

et al. 2022

Journal of Surgical Case Reports

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The impact of long-standing human immunodeficiency virus infection (HIV) and potent anti-retroviral therapy on the coronary circulation is unknown; however, scattered reports are emerging of coronary aneurysms in this population. We report what we believe to be the first described case of both coronary stenosis and coronary artery aneurysms in a person living with HIV and discuss management options.

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“…CAAs have not been well documented in patients with HIV [ 3 ]. There is one recent report of a 22-year-old male with HIV who presented with ST-segment elevation MI related to CAAs [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Multiple coronary aneurysms in a young adult with acquired immunodeficiency syndrome

2016

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HIV infection can cause multiple deleterious effects on the cardiovascular system. Emerging evidence has supported a direct association between HIV infection and accelerated atherosclerosis. The mechanism for atherosclerosis in HIV-positive patients is multifactorial, an interplay between conventional risk factors, HIV itself and highly active antiretroviral therapy. The case described is a 29-year-old man with HIV, non-adherent to antiretroviral therapy and with few cardiovascular risk factors, who presented with chest pain and non-ST elevation myocardial infarction. Cardiac catheterization revealed multiple coronary artery aneurysms in the left main coronary artery and the right coronary artery. Aneurysmal formation may develop from vasculitis, HIV itself, accelerated atherosclerosis, congenital formation or medications (e.g. protease inhibitors). The researchers provide a review of coronary artery disease, aneurysmal formation and vasculitic processes in the context of HIV. As this clinical entity becomes more apparent, alternative therapeutic options may need to be explored.

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Acute Coronary Thrombosis and Multiple Coronary Aneurysms in a 22-Year-Old Man with the Human Immunodeficiency Virus

Cited by 9 publications

References 12 publications

Very Early Coronary Artery Aneurysm After Primary Percutaneous Coronary Intervention in Patient With HIV and Thrombophilia

Very Early Coronary Artery Aneurysm After Primary Percutaneous Coronary Intervention in Patient With HIV and Thrombophilia

Coronary artery aneurysm, ectasia and stenosis in a 53-year-old man with HIV infection

Multiple coronary aneurysms in a young adult with acquired immunodeficiency syndrome

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