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Coronary artery disease in HIV infected patients

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Abstract

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/mm3), 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.

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Authors and Affiliations

  1. Service des Maladies Infectieuses, Hôpital Paul Brousse, 12–14 avenue Paul Vaillant Couturier, 94804, Villejuif, France

    Lelia Escaut, Jean Jacques Monsuez, Mansouriah Merad, Elina Teicher, Denis Smadja & Daniel Vittecoq

  2. Service des Maladies Cardiovasculaires, Hôpital Broussais, Paris, France

    Gilles Chironi & Alain Simon

Authors
  1. Lelia Escaut
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  2. Jean Jacques Monsuez
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  3. Gilles Chironi
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  4. Mansouriah Merad
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  5. Elina Teicher
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  6. Denis Smadja
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  7. Alain Simon
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  8. Daniel Vittecoq
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Corresponding author

Correspondence to Daniel Vittecoq.

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Escaut, L., Monsuez, J.J., Chironi, G. et al. Coronary artery disease in HIV infected patients. Intensive Care Med 29, 969–973 (2003). https://doi.org/10.1007/s00134-003-1740-0

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  • DOI: https://doi.org/10.1007/s00134-003-1740-0

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