Increased Acute Myocardial Infarction Rates and Cardiovascular Risk Factors among Patients with Human Immunodeficiency Virus Disease

Triant, Virginia A.; Lee, Hang; Hadigan, Colleen; Grinspoon, Steven

doi:10.1210/jc.2006-2190

Cited by 1,427 publications

(1,217 citation statements)

References 24 publications

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“…Coincident with improved survival, patterns of co-morbidity and mortality have changed among HIV-positive patients: cardiovascular disease, hypertension, and diabetes have become prevalent, [9][10][11] and causes of death have shifted from opportunistic infections to end-stage liver and kidney disease and non-HIV-related malignancies (Table 1). [12][13][14] Research also shows that HIV infection directly affects other organ systems, manifesting as chronic conditions including HIV-associated neurocognitive disorder and pulmonary hypertension.…”

Section: Changing Patients: Morbidity Mortality and Agingmentioning

confidence: 99%

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

2011

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Since the beginning of the AIDS epidemic, models of HIV care have needed to be invented or modified as the needs of patients and communities evolved. Early in the epidemic, primary care and palliative care predominated; subsequently, the emergence of effective therapy for HIV infection led to further specialization and a focus on increasingly complex antiretroviral therapy as the cornerstone of effective HIV care. Over the past decade, factors including (1) an aging, long-surviving population; (2) multiple co-morbidities; (3) polypharmacy; and (4) the need for chronic disease management have led to a need for further evolution of HIV care models. Moreover, geographic diffusion; persistent disparities in timely HIV diagnosis, treatment access, and outcomes; and the aging of the HIV provider workforce also suggest the importance of reincorporating primary care providers into the spectrum of HIV care in the current era. Although some HIV-dedicated treatment centers offer comprehensive medical services, other models of HIV care potentially exist and should be developed and evaluated. In particular, primary care-and community-based collaborative practices-where HIV experts or specialists are incorporated into existing health centers-are one approach that combines the benefits of HIV-specific expertise and comprehensive primary care using an integrated, patient-centered approach.

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Section: Changing Patients: Morbidity Mortality and Agingmentioning

confidence: 99%

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

2011

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“…3,8,9 In a study carried out by the Antiretroviral Therapy Cohort Collaboration, 6 which included 39 272 patients from 13 cohorts of patients receiving HAART between 1996 and 2006 in Europe and the USA, mortality attributed to cardiovascular disease in HIV patients was 7.9% (40% of which was due to CAD or myocardial infarction [MI] and 18% to stroke). The D:A:D study, 7 which was completed later and included 49 731 patients followed between 1999 and 2011 in clinics in Europe, the USA and Australia, reported mortality of 11% due to cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

HIV and coronary disease – When secondary prevention is insufficient

Carvalho

Valente

Morais

et al. 2017

Revista Portuguesa de Cardiologia (English Edition)

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Highly active antiretroviral therapy (HAART) has created a new paradigm for human immunodeficiency virus (HIV)-infected patients, but their increased risk for coronary disease is well documented.We present the case of a 57-year-old man, co-infected with HIV-2 and hepatitis B virus, adequately controlled and with insulin-treated type 2 diabetes and dyslipidemia, who was admitted with non-ST elevation acute myocardial infarction. Coronary angiography performed on day four of hospital stay documented two-vessel disease (mid segment of the right coronary artery [RCA, 90% stenosis] and the first marginal). Tw o drug-eluting stents were successfully implanted. The patient was discharged under dual antiplatelet therapy (aspirin 100 mg/day and clopidogrel 75 mg/day) and standard coronary artery disease medication. He was admitted to the emergency room four hours after discharge with chest pain radiating to the left arm and inferior ST-segment elevation myocardial infarction was diagnosed. Coronary angiography was performed within one hour and documented thrombosis of both stents. Optical coherence tomography revealed good apposition of the stent in the RCA, with intrastent thrombus. Angioplasty was performed, with a good outcome.The acute stent thrombosis might be explained by the thrombotic potential of HIV infection and diabetes. There are no specific guidelines regarding HAART in secondary prevention of acute coronary syndromes. A multidisciplinary approach is essential for optimal management of these patients. © 2017 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. All rights reserved. Document downloaded from http://www.elsevier.es, day 24/08/2017. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. Document downloaded from http://www.elsevier.es, day 24/08/2017. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. 569.e2A.S. Carvalho et al. PALAVRAS-CHAVEVírus da imunodeficiência humana; Trombose de stent; Doença coronária VIH e doença coronária ---quando a prevenção secundária é insuficienteResumo A terapêutica antiretroviral (TARV) alterou o paradigma da infeção pelo vírus da imunodeficiência humana (VIH), conhecendo-se o risco aumentado de doença coronária nestes doentes.Apresenta-se o caso de um homem de 57 anos, melanodérmico, com coinfecção VIH-2/vírus hepatite B, com controlo adequado; diabetes mellitus tipo 2, insulino-tratado e dislipidemia. Internado por enfarte agudo do miocárdio, sem supradesnivelamento ST. Realizou cateterismo ao 4.• dia de internamento, documentando-se doença de dois vasos (segmento médio da coronária direita [CD] [90% estenose] e 1. a obtusa marginal [OM1] com estenose de 95%). Colocaram-se dois stents revestidos, sem intercorrências. Teve alta sob dupla antiagregação (ácido acetilsalicílico 100 mg/dia e clopidogrel 75 mg/dia) e restante terapêutica dirigida à doença coronária. Recorreu ao serviço de urgência quatro horas após a alt...

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“…In 2011–2012, in the 22 countries with the highest burden of antenatal HIV infection only 31 % (29–33 %) of children aged 15 years and below, eligible for antiretroviral (ARV) treatment received it; additionally the percentage increase in children accessing antiretroviral therapy was approximately half that of adults (11 % vs. 21 %) (WHO et al 2013). Successful prevention or early, regular treatment of paediatric HIV infection, is critical to reduce short-and long-term morbidity and mortality in children aged 0–18 years (Bernays et al 2014; Triant et al 2013). …”

Section: Introductionmentioning

confidence: 99%

Enhancing HIV Treatment Access and Outcomes Amongst HIV Infected Children and Adolescents in Resource Limited Settings

Goga

Singh

et al. 2016

Matern Child Health J

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Introduction Increasing access to HIV-related care and treatment for children aged 0–18 years in resource-limited settings is an urgent global priority. In 2011–2012 the percentage increase in children accessing antiretroviral therapy was approximately half that of adults (11 vs. 21 %). We propose a model for increasing access to, and retention in, paediatric HIV care and treatment in resource-limited settings. Methods Following a rapid appraisal of recent literature seven main challenges in paediatric HIV-related care and treatment were identified: (1) lack of regular, integrated, ongoing HIV-related diagnosis; (2) weak facility-based systems for tracking and retention in care; (3) interrupted availability of dried blood spot cards (expiration/stock outs); (4) poor quality control of rapid HIV testing; (5) supply-related gaps at health facility-laboratory interface; (6) poor uptake of HIV testing, possibly relating to a fatalistic belief about HIV infection; (7) community-associated reasons e.g. non-disclosure and weak systems for social support, resulting in poor retention in care. Results To increase sustained access to paediatric HIV-related care and treatment, regular updating of Policies, review of inter-sectoral Plans (at facility and community levels) and evaluation of Programme implementation and impact (at national, subnational, facility and community levels) are non-negotiable critical elements. Additionally we recommend the intensified implementation of seven main interventions: (1) update or refresher messaging for health care staff and simple messaging for key staff at early childhood development centres and schools; (2) contact tracing, disclosure and retention monitoring; (3) paying particular attention to infant dried blood spot (DBS) stock control; (4) regular quality assurance of rapid HIV testing procedures; (5) workshops/meetings/dialogues between health facilities and laboratories to resolve transport-related gaps and to facilitate return of results to facilities; (6) community leader and health worker advocacy at creches, schools, religious centres to increase uptake of HIV testing and dispel fatalistic beliefs about HIV; (7) use of mobile communication technology (m-health) and peer/community supporters to maintain contact with patients. Discussion and Conclusion We propose that this package of facility, community and family-orientated interventions are needed to change the trajectory of the paediatric HIV epidemic and its associated patterns of morbidity and mortality, thus achieving the double dividend of improving HIV-free survival.

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Increased Acute Myocardial Infarction Rates and Cardiovascular Risk Factors among Patients with Human Immunodeficiency Virus Disease

Abstract: AMI rates and cardiovascular risk factors were increased in HIV compared with non-HIV patients, particularly among women. Cardiac risk modification strategies are important for the long-term care of HIV patients.

Cited by 1,427 publications

References 24 publications

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

HIV and coronary disease – When secondary prevention is insufficient

Enhancing HIV Treatment Access and Outcomes Amongst HIV Infected Children and Adolescents in Resource Limited Settings

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