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Coronary Artery Disease

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Abstract

Cardiovascular disease, in particular coronary artery disease, is prevalent in patients infected with HIV. Research has shown that these patients are at higher risk when compared to the general population. Factors contributing to this risk include traditional risk factors as well as factors unique to this patient population. The increased risk is also reflective of lifestyle choices such as smoking and socioeconomic factors such as less access to healthy foods and opportunities for exercise and physical activity and preventive care.

Pathophysiology of atherosclerosis is different in patients living with HIV and factors such as inflammation and metabolic abnormalities impact on the development of cardiovascular disease.

There are no comprehensive guidelines for the care of patients infected with HIV who have heart attack, and at present it is recommended that guidelines for the general population are followed with consideration for the aspects that are unique to patients infected with HIV.

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References

  1. Writing Group, M, et al. Heart disease and stroke statistics-2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38–360.

    Google Scholar 

  2. World Health Organization. HIV/AIDS. 2016 [cited 2016 20 Dec]; Available from: http://www.who.int/hiv/data/en/

  3. Lang S, et al. Increased risk of myocardial infarction in HIV-infected patients in France, relative to the general population. AIDS. 2010;24(8):1228–30.

    PubMed  Google Scholar 

  4. Freiberg MS, et al. HIV infection and the risk of acute myocardial infarction. JAMA Intern Med. 2013;173(8):614–22.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Triant VA, et al. Increased acute myocardial infarction rates and cardiovascular risk factors among patients with human immunodeficiency virus disease. J Clin Endocrinol Metab. 2007;92(7):2506–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Davies MJ, et al. Morphology of the endothelium over atherosclerotic plaques in human coronary arteries. Br Heart J. 1988;60(6):459–64.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Iantorno M, et al. Coronary artery endothelial dysfunction is present in HIV-positive individuals without significant coronary artery disease. AIDS. 2017;31(9):1281–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Currier JS, et al. Coronary heart disease in HIV-infected individuals. J Acquir Immune Defic Syndr. 2003;33(4):506–12.

    PubMed  Google Scholar 

  9. Kamin DS, Grinspoon SK. Cardiovascular disease in HIV-positive patients. AIDS. 2005;19(7):641–52.

    PubMed  Google Scholar 

  10. van Lelyveld SF, et al. Long-term complications in patients with poor immunological recovery despite virological successful HAART in Dutch ATHENA cohort. AIDS. 2012;26(4):465–74.

    PubMed  Google Scholar 

  11. Post WS, Budoff M, Kingsley L, Palella FJ Jr, Witt MD, Li X, George RT, Brown TT, Jacobson LP. Associations between HIV infection and subclinical coronary atherosclerosis. Ann Intern Med. 2014;160:458.

    PubMed  PubMed Central  Google Scholar 

  12. Ahmadi N, et al. Mortality incidence of patients with non-obstructive coronary artery disease diagnosed by computed tomography angiography. Am J Cardiol. 2011;107(1):10–6.

    PubMed  Google Scholar 

  13. Lang S, et al. HIV replication and immune status are independent predictors of the risk of myocardial infarction in HIV-infected individuals. Clin Infect Dis. 2012;55(4):600–7.

    CAS  PubMed  Google Scholar 

  14. Strategies for Management of Antiretroviral Therapy Study, G, et al. Inferior clinical outcome of the CD4+ cell count-guided antiretroviral treatment interruption strategy in the SMART study: role of CD4+ Cell counts and HIV RNA levels during follow-up. J Infect Dis. 2008;197(8):1145–55.

    Google Scholar 

  15. Silverberg MJ, et al. Immunodeficiency and risk of myocardial infarction among HIV-positive individuals with access to care. J Acquir Immune Defic Syndr. 2014;65(2):160–6.

    CAS  PubMed  Google Scholar 

  16. Armah KA, et al. HIV status, burden of comorbid disease, and biomarkers of inflammation, altered coagulation, and monocyte activation. Clin Infect Dis. 2012;55(1):126–36.

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Merlini E, et al. T-cell phenotypes, apoptosis and inflammation in HIV+ patients on virologically effective cART with early atherosclerosis. PLoS One. 2012;7(9):e46073.

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Kelesidis T, et al. Biomarkers of microbial translocation and macrophage activation: association with progression of subclinical atherosclerosis in HIV-1 infection. J Infect Dis. 2012;206(10):1558–67.

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Shor-Posner G, et al. Hypocholesterolemia is associated with immune dysfunction in early human immunodeficiency virus-1 infection. Am J Med. 1993;94(5):515–9.

    CAS  PubMed  Google Scholar 

  20. Wohl D, et al. The associations of regional adipose tissue with lipid and lipoprotein levels in HIV-infected men. J Acquir Immune Defic Syndr. 2008;48(1):44–52.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Currier J, et al. Regional adipose tissue and lipid and lipoprotein levels in HIV-infected women. J Acquir Immune Defic Syndr. 2008;48(1):35–43.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Grunfeld C, et al. Lipids, lipoproteins, triglyceride clearance, and cytokines in human immunodeficiency virus infection and the acquired immunodeficiency syndrome. J Clin Endocrinol Metab. 1992;74(5):1045–52.

    CAS  PubMed  Google Scholar 

  23. Riddler SA, et al. Impact of HIV infection and HAART on serum lipids in men. JAMA. 2003;289(22):2978–82.

    CAS  PubMed  Google Scholar 

  24. Jacobson TA, et al. National lipid association recommendations for patient-centered management of dyslipidemia: part 2. J Clin Lipidol. 2015;9(6 Suppl):S1–122. e1.

    Google Scholar 

  25. Magkos F, Mantzoros CS. Body fat redistribution and metabolic abnormalities in HIV-infected patients on highly active antiretroviral therapy: novel insights into pathophysiology and emerging opportunities for treatment. Metabolism. 2011;60(6):749–53.

    CAS  PubMed  Google Scholar 

  26. Galescu O, Bhangoo A, Ten S. Insulin resistance, lipodystrophy and cardiometabolic syndrome in HIV/AIDS. Rev Endocr Metab Disord. 2013;14(2):133–40.

    CAS  PubMed  Google Scholar 

  27. Estrada V, Portilla J. Dyslipidemia related to antiretroviral therapy. AIDS Rev. 2011;13(1):49–56.

    PubMed  Google Scholar 

  28. Rudich A, et al. Cellular mechanisms of insulin resistance, lipodystrophy and atherosclerosis induced by HIV protease inhibitors. Acta Physiol Scand. 2005;183(1):75–88.

    CAS  PubMed  Google Scholar 

  29. Brothers CH, et al. Risk of myocardial infarction and abacavir therapy: no increased risk across 52 GlaxoSmithKline-sponsored clinical trials in adult subjects. J Acquir Immune Defic Syndr. 2009;51(1):20–8.

    CAS  PubMed  Google Scholar 

  30. Ribaudo HJ, et al. No risk of myocardial infarction associated with initial antiretroviral treatment containing abacavir: short and long-term results from ACTG A5001/ALLRT. Clin Infect Dis. 2011;52(7):929–40.

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Cruciani M, et al. Abacavir use and cardiovascular disease events: a meta-analysis of published and unpublished data. AIDS. 2011;25(16):1993–2004.

    CAS  PubMed  Google Scholar 

  32. Sax PE, et al. Tenofovir alafenamide vs. tenofovir disoproxil fumarate in single tablet regimens for initial HIV-1 therapy: a randomized phase 2 study. J Acquir Immune Defic Syndr. 2014;67(1):52–8.

    CAS  PubMed  Google Scholar 

  33. Mills A, et al. Tenofovir alafenamide versus tenofovir disoproxil fumarate in the first protease inhibitor-based single-tablet regimen for initial HIV-1 therapy: a randomized phase 2 study. J Acquir Immune Defic Syndr. 2015;69(4):439–45.

    CAS  PubMed  Google Scholar 

  34. Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV. Department of Health and Human Services. Available at http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed 28 Jan 2019.

  35. Aberg JA, et al. Primary care guidelines for the management of persons infected with HIV: 2013 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2014;58(1):1–10.

    PubMed  Google Scholar 

  36. Aslangul E, et al. Rosuvastatin versus pravastatin in dyslipidemic HIV-1-infected patients receiving protease inhibitors: a randomized trial. AIDS. 2010;24(1):77–83.

    CAS  PubMed  Google Scholar 

  37. Boccara F, et al. Statin therapy and low-density lipoprotein cholesterol reduction in HIV-infected individuals after acute coronary syndrome: results from the PACS-HIV lipids substudy. Am Heart J. 2017;183:91–101.

    CAS  PubMed  Google Scholar 

  38. Perello R, et al. Clinical presentation of acute coronary syndrome in HIV infected adults: a retrospective analysis of a prospectively collected cohort. Eur J Intern Med. 2011;22(5):485–8.

    CAS  PubMed  Google Scholar 

  39. Smilowitz NR, et al. Influence of human immunodeficiency virus seropositive status on the in-hospital management and outcomes of patients presenting with acute myocardial infarction. J Invasive Cardiol. 2016;28(10):403–9.

    PubMed  Google Scholar 

  40. Crane HM, et al. Types of myocardial infarction among human immunodeficiency virus-infected individuals in the United States. JAMA Cardiol. 2017;2(3):260–7.

    PubMed  PubMed Central  Google Scholar 

  41. Albaeni A, et al. HIV status and type of coronary stent placed in patients presenting with ST-elevation myocardial infarction. Coron Artery Dis. 2017;28:239–45.

    PubMed  Google Scholar 

  42. D’Ascenzo F, et al. Prognostic indicators for recurrent thrombotic events in HIV-infected patients with acute coronary syndromes: use of registry data from 12 sites in Europe, South Africa and the United States. Thromb Res. 2014;134(3):558–64.

    PubMed  Google Scholar 

  43. Peyriere H, et al. Antihypertensive drugs in patients treated with antiretrovirals. Ann Pharmacother. 2012;46(5):703–9.

    PubMed  Google Scholar 

  44. Ranade K, et al. Genetic analysis implicates resistin in HIV lipodystrophy. AIDS. 2008;22(13):1561–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  45. Wilmington DA. Brilinta (ticagrelor) [prescribing information]. 2016.

    Google Scholar 

  46. Deeks ED. Cobicistat: a review of its use as a pharmacokinetic enhancer of atazanavir and darunavir in patients with HIV-1 infection. Drugs. 2014;74(2):195–206.

    CAS  PubMed  Google Scholar 

  47. Zeldin RK, Petruschke RA. Pharmacological and therapeutic properties of ritonavir-boosted protease inhibitor therapy in HIV-infected patients. J Antimicrob Chemother. 2004;53(1):4–9.

    CAS  PubMed  Google Scholar 

  48. Slama L, et al. Inaccuracy of haemoglobin A1c among HIV-infected men: effects of CD4 cell count, antiretroviral therapies and haematological parameters. J Antimicrob Chemother. 2014;69(12):3360–7.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Kim PS, et al. A1C underestimates glycemia in HIV infection. Diabetes Care. 2009;32(9):1591–3.

    CAS  PubMed  PubMed Central  Google Scholar 

  50. Gilbert JM, Fitch KV, Grinspoon SK. HIV-related cardiovascular disease, statins, and the REPRIEVE trial. Top Antivir Med. 2015;23(4):146–9.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Advanced Heart Failure and Transplant Cardiology, North Shore University Hospital, Northwell Health, Manhasset, NY, USA

    Patricia Chavez

  2. Department of Medicine, Mount Sinai St. Luke’s and Mount Sinai West Hospitals, New York, NY, USA

    Di Pan

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  1. Patricia Chavez
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Correspondence to Patricia Chavez .

Editor information

Editors and Affiliations

  1. Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA

    Merle Myerson

  2. Division of Infectious Diseases, Weill Cornell Medical College, New York, NY, USA

    Marshall J. Glesby

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Chavez, P., Pan, D. (2019). Coronary Artery Disease. In: Myerson, M., Glesby, M. (eds) Cardiovascular Care in Patients With HIV. Springer, Cham. https://doi.org/10.1007/978-3-030-10451-1_9

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  • DOI: https://doi.org/10.1007/978-3-030-10451-1_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-10450-4

  • Online ISBN: 978-3-030-10451-1

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