Clinical presentation of acute coronary syndrome in HIV infected adults: A retrospective analysis of a prospectively collected cohort

Perelló, Rafel; Calvo, Marta; Miró, Òscar; Castañeda, Marta; Saubí, Narcís; Camón, Silvia; Foix, Anna; Gatell, J.M.; Masotti, Mónica; Mallolas, J; Sanchez, Maria Camila; Martínez, Enrique Toledo

doi:10.1016/j.ejim.2011.02.017

Cited by 30 publications

(35 citation statements)

References 27 publications

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“…The very high rates of smoking, hypertension, dyslipidemia, and diabetes we observed in our group were consistent with those of other cohorts of HIV-1-infected patients with myocardial infarction [19, 31, 41, 42]. …”

Section: Discussionsupporting

confidence: 92%

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

Echeverría

Domingo

Llibre

et al. 2014

BioMed Research International

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Background. There are conflicting data on the prevalence of coronary events and the quality of the management of modifiable cardiovascular risk factors (CVRF) in HIV-infected patients. Methods. We performed a retrospective descriptive study to determine the prevalence of coronary events and to evaluate the management of CVRF in a Mediterranean cohort of 3760 HIV-1-infected patients from April 1983 through June 2011. Results. We identified 81 patients with a history of a coronary event (prevalence 2.15%); 83% of them suffered an acute myocardial infarction. At the time of the coronary event, CVRF were highly prevalent (60.5% hypertension, 48% dyslipidemia, and 16% diabetes mellitus). Other CVRF, such as smoking, hypertension, lack of exercise, and body mass index, were not routinely assessed. After the coronary event, a significant decrease in total cholesterol (P = 0.025) and LDL-cholesterol (P = 0.004) was observed. However, the percentage of patients who maintained LDL-cholesterol > 100 mg/dL remained stable (from 46% to 41%, P = 0.103). Patients using protease inhibitors associated with a favorable lipid profile increased over time (P = 0.028). Conclusions. The prevalence of coronary events in our cohort is low. CVRF prevalence is high and their management is far from optimal. More aggressive interventions should be implemented to diminish cardiovascular risk in HIV-infected patients.

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Section: Discussionsupporting

confidence: 92%

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

Echeverría

Domingo

Llibre

et al. 2014

BioMed Research International

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“…34 An alternative potential explanation relates to selection bias and delayed stress testing. If providers have a higher threshold to order stress tests for HIV-infected patients due to concerns regarding competing co-morbidities and increasing polypharmacy, they may tend to refer patients more likely to truly require PCI.…”

Section: Discussionmentioning

confidence: 99%

Differences by HIV serostatus in coronary artery disease severity and likelihood of percutaneous coronary intervention following stress testing

Feinstein

Poole

Gonzalez

et al. 2018

Journal of Nuclear Cardiology

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Background HIV-infected persons develop coronary artery disease (CAD) more commonly and earlier than uninfected persons; however, the role of non-invasive testing to stratify CAD risk in HIV is not well defined. Methods and results Patients were selected from a single-center electronic cohort of HIV-infected patients and uninfected controls matched 1:2 on age, sex, race, and type of cardiovascular testing performed. Patients with abnormal echocardiographic or nuclear stress testing who subsequently underwent coronary angiography were included. Logistic regressions were used to assess differences by HIV serostatus in two co-primary endpoints: (1) severe CAD (≥70% stenosis of at least one coronary artery) and (2) performance of percutaneous coronary intervention (PCI). HIV-infected patients (N = 189) were significantly more likely to undergo PCI following abnormal stress test when compared with uninfected persons (N = 319) after adjustment for demographics, CAD risk factors, previous coronary intervention, and stress test type (OR 1.85, 95% CI 1.12-3.04, P = 0.003). No associations between HIV serostatus and CAD were statistically significant, although there was a non-significant trend toward greater CAD for HIV-infected patients. Conclusions HIV-infected patients with abnormal cardiovascular stress testing who underwent subsequent coronary angiography did not have a significantly greater CAD burden than uninfected controls, but were significantly more likely to receive PCI.

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“…Se han documentado diferencias clínicas y angiográficas en la presentación de síndromes coronarios agudos en pacientes con VIH, incluidas mayores tasas de reestenosis 47 y presentación más frecuente de IAM con elevación del segmento ST versus IAM sin elevación del segmento ST, o angina inestable en pacientes VIH frente a los controles 48 .…”

Section: Enfermedad Arterial Coronaria E Infarto De Miocardiounclassified

Enfermedad cardiovascular y metabólica en pacientes infectados por el virus de la inmunodeficiencia humana

Camargo-Ariza

Galvis-Blanco

Gualdrón-Rincón

et al. 2017

revmed

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Clinical presentation of acute coronary syndrome in HIV infected adults: A retrospective analysis of a prospectively collected cohort

Cited by 30 publications

References 27 publications

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

Prevalence of Ischemic Heart Disease and Management of Coronary Risk in Daily Clinical Practice: Results from a Mediterranean Cohort of HIV-Infected Patients

Differences by HIV serostatus in coronary artery disease severity and likelihood of percutaneous coronary intervention following stress testing

Enfermedad cardiovascular y metabólica en pacientes infectados por el virus de la inmunodeficiencia humana

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