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Background: Individuals living with human immunodeficiency virus (HIV) are reported to have a higher risk for atherosclerotic disease due to both the individual and combined effects of their HIV and their antiretroviral therapy (ART). The objective of this study was to determine differences in risk factors and coronary anatomy when comparing HIV patients to a seronegative cohort.
Methods: A retrospective database study was undertaken matching the provincial HIV clinical cohort databases in Alberta, Canada with the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease database to determine a common cohort of HIV patients who also underwent cardiac catheterization. An HIV negative cohort matched in a 4:1 fashion by age, gender, smoking status, and indication for coronary angiography was obtained and charts were analyzed for prevalence of traditional cardiac risk factors, distribution of coronary artery disease (CAD) at first coronary angiogram, and frequency of percutaneous or surgical interventions done. Significant lesions were defined as ≥70% stenosis.
Results: From 1996-2014, 94 seropositive individuals underwent angiography. In both groups, the mean age was 53±9, 65% had diffuse coronary disease and 69% presented with ACS. Hypertension was more prevalent (56% vs 29%, p<0.01) and BMI was higher (28±3 vs. 25±5, p<0.01) in the seronegative group. Prevalence of diabetes was the same in both groups (22 vs. 15, p=0.1). Seronegative individuals had more significant single-vessel CAD compared to the seropositive group (59% vs. 39%, p<0.01) and there were more interventions performed in the seronegative cohort (44 vs. 66, <0.01). Triple vessel CAD was the same in both groups (16%).
Conclusions: A seronegative group had a higher BMI, greater prevalence of hypertension, higher incidence of single-vessel disease and underwent more interventions compared to a seropositive group of similar age, gender, smoking status, and indication for angiography. This may imply that HIV infection or ART increases risk for CAD, but seropositive patients are either not offered intervention or have lesions not amenable to intervention.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Traditional and Novel Factors Used to Assess the Risk of, and Used for the Treatment of, Coronary Artery Disease
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1126-344
- 2017 American College of Cardiology Foundation