Angiographic Features and Cardiovascular Risk Factors in Human Immunodeficiency Virus-Infected Patients With First-Time Acute Coronary Syndrome

• Published in: The American journal of cardiology Vol. 111; no. 1; pp. 63 - 67
• Main Authors: Knudsen, Andreas, MD, Mathiasen, Anders B., MD, Worck, René H., PhD, Kastrup, Jens, DMSc, Gerstoft, Jan, DMSc, Katzenstein, Terese L., DMSc, Kjær, Andreas, DMSc, Lebech, Anne-Mette, DMSc
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2013; Elsevier Limited
• Subjects: Acute Coronary Syndrome - complications; Acute Coronary Syndrome - diagnostic imaging; Acute Coronary Syndrome - epidemiology; Acute coronary syndromes; Adult; Aged; Angina pectoris; Cardiovascular; Cardiovascular disease; Cholesterol; Coronary Angiography; Denmark - epidemiology; Drug therapy; Female; Follow-Up Studies; Heart attacks; Hepatitis; HIV; HIV Infections - complications; HIV Infections - epidemiology; Human immunodeficiency virus; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Risk Factors; Denmark
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2012.08.047

A matched cohort study was conducted comparing patients with first-time acute coronary syndromes infected with human immunodeficiency virus (HIV) to non-HIV-infected patients with and without diabetes matched for smoking, gender, and type of acute coronary syndrome who underwent first-time coronary angiography. A total of 48 HIV-infected patients were identified from a national database. Coronary angiography showed that the HIV-infected patients had significantly fewer lesions with classification B2/C than the 2 control groups (p <0.001) but the same extent of multivessel disease. The HIV-infected patients were a decade younger than the non-HIV-infected controls and had significantly higher concentrations of total cholesterol (6.3 vs 4.8 and 4.5 mmol/L, p <0.0001), low-density lipoprotein (4.0 vs 2.9 and 2.5 mmol/L, p <0.001), and triglycerides (2.8 vs 1.0 and 1.4 mmol/L, p <0.01) compared to the nondiabetic and diabetic non-HIV-infected groups, respectively. In conclusion, HIV-infected patients with first-time acute coronary syndromes have fewer complex lesions than non-HIV-infected patients. This finding supports the idea that the pathogenesis of atherosclerotic disease in HIV patients is different from that in the general population.