The purpose of this study is to analyze coronary disease in HIV patients.
In recent years, ACS have been described in HIV patients. We analysed coronary disease in HIV patients.
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.
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.
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.
M. Benhamou, None.