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Acute Coronary Syndrome in HIV Patients: Angiographic Features; A Case Control Study FREE TO VIEW

Mustapha Benhamou, MD; Emile Ferrari, MD; Pierre Cerboni, MD; Michel Carles, MD; Michel Thiry, MD; Marcel Baudouy, MD
Author and Funding Information

Pasteur Hospital, Nice, France


Chest. 2003;124(4_MeetingAbstracts):148S-c-149S. doi:10.1378/chest.124.4_MeetingAbstracts.148S-c
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OBJECTIVES:  The purpose of this study is to analyze coronary disease in HIV patients.

BACKGROUND:  In recent years, ACS have been described in HIV patients. We analysed coronary disease in HIV patients.

METHOD:  A case control study was used to compare HIV patients with 52 non-HIV patients both consecutively hospitalized with a first acute coronary syndrome (ACS). Risk factors and coronary angiogram were analyzed. Clinical evolution at one year is reported.

RESULTS:  From 1997 to 2002, 26 HIV patients were admitted with an ACS. Mean age was 47± 8. We show in the HIV group a less frequent excess weight: 7.6% vs 40%, p = 0.003, a lower LDL-cholesterol (LDL-C): 1.27 ± 0.48 g/l vs 1.47 ± 0.39 g/l, p = 0.047 and a higher triglycerides (TG) rate: 3.07 ± 2.28 g/l vs 1.78 ± 0.77 g/l, p = 0.0004. Type A lesions were more often found in the HIV group: 44% vs 2%, p < 0.05.Regardless the culprit lesion, atheroma was less frequently found in the HIV group: both on the culprit vessel (48% vs 81%, p = 0.007) and in the whole coronary network (58% vs 77%, p = 0,09). Seven HIV patients (27%) vs 2 non-HIV patients (3,8%) were hospitalized within 9 months due to a relapsed ACS: p=0.005.

CONCLUSION:  HIV coronary patients have a greater TG rate and a reduced LDL-C. Their SCA occurs in a coronary network relatively unaffected with atherosclerosis. The culprit lesion is often a type A lesion which lends itself readily to revascularization by PTCA. At last, in our study, coronary disease of HIV patient is characterized by a tendancy to relapse.

DISCLOSURE:  M. Benhamou, None.

Wednesday, October 29, 2003

12:30 PM - 2:00 PM




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