Author/Editor		Matetzky, Shlomo; Domingo, Michelle; Kar, Saibal; Noč, Marko; Shah, Prediman K; Kaul, Sanjay; Daar, Eric; Čerček, Bojan
Title		Acute myocardial infarction in human immunodeficincy virus-infected patients
Type		članek
Source		Arch Intern Med
Vol. and No.		Letnik 163, št. 4
Publication year		2003
Volume		str. 457-60
Language		eng
Abstract		Background Patients infected with human immunodeficiency virus (HIV) are at an increased risk for premature coronary artery disease. However, the clinical outcome of HIV-infected patients who have had an acute myocardial infarction (AMI) is unknown. Methods We studied 24 consecutive HIV-infected patients admitted because of AMI. During the hospital phase, the patients were examined for recurrent ischemia, congestive heart failure, arrhythmia, and death. Patients were followed up for an average of 15 months after discharge for reinfarction; recurrent angina; the need for any angioplasty, bypass surgery, or target vessel revascularization for restenosis and stent thrombosis; HIV-related complications; and death. For comparison, we included a matched control group of non-HIV-infected patients. Results The HIV-infected patients with AMI were predominantly male (21 [88%]), 47 ± 9 years of age. Twenty-two (92%) were receiving antiretroviral treatment; 17 (71%), protease inhibitors; and 13 (54%), lipid-lowering therapy. With aggressive therapy, the lipid profile was similar in HIV-infected patients treated with protease inhibitors and those who were not. Twenty-one (88%) of 24 patients underwent immediate angiography and 20 (83%) had angioplasty or bypass surgery. The HIV-infected patients with AMI had a benign inhospital course, with no deaths or reinfarction. The admission characteristics, treatment strategy, and in-hospital outcome were similar in the matched uninfected patients with AMI. After discharge, HIV-infected patients had a higher incidence of reinfarction (4/20 [20%] vs 2/45 [4%]; P = .07), and 6 (43%) of 14 HIV-infected patients who had successful percutaneous coronary intervention and were available for follow-up required target vessel revascularization compared with 4 (11 %) of 38 uninfected patients who had successful percutaneous coronary intervention and were available for follow-up (P = .02). (Abstract truncated at 2000 characters).
Descriptors		HIV INFECTIONS MYOCARDIAL INFARCTION HEART FAILURE, CONGESTIVE ANGINA PECTORIS ARRHYTHMIA CORONARY ANGIOGRAPHY CORONARY ARTERY BYPASS PROTEASE INHIBITORS HOSPITALIZATION FOLLOW-UP STUDIES